An improved technique for the study of lymph nodes in surgical specimens

The importance of the meticulous study by pathologists of the lymph nodes in surgical specimens is emphasized. Most pathologists identify only a small proportion of the lymph nodes in these specimens and valuable prognostic information is lost. Data illustrating the evolution in the Columbia Laboratory of surgical pathology of methods used to study surgical lymph node specimens over a 44-year period (1935--1979) are reviewed. An improved method of clearing the specimens of axillary dissections in radical mastectomy finds more lymph nodes and more metastases, and greatly shortens the time required for clearing. The importance of identifying metastases in the interpectoral nodes is emphasized. In a special study with our new clearing technique metastases were found in the interpectoral nodes in 19% of the radical mastectomy specimens. These nodes are not removed in the modified operation, which does not include resection of the pectoral muscles. The opportunity to cure a substantial proportion of patients is thus lost.