The use of cytokeratin staining in sentinel lymph node biopsy for breast cancer

Sandra L. Wong, Celia Chao, Michael J. Edwards, Diana Simpson, Kelly M. McMasters

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


Background: Controversy exists regarding the routine use of cytokeratin immunohistochemistry (IHC) in the histopathologic examination of breast cancer sentinel lymph nodes (SLN) because the clinical significance of micrometastases detected by IHC is unclear. This analysis was performed to determine the frequency of IHC-detected micrometastases. Methods: All patients underwent SLN biopsy, followed by completion axillary dissection. This analysis included patients who had SLN evaluated by IHC. SLN were examined by hematoxylin and eosin (H&E) stain at 2-mm intervals, with IHC in 2 sections. The axillary dissection specimen was evaluated by routine H&E staining. Results: IHC was performed in SLNs from 973 patients. Of the 869 patients with negative nodes by H&E, 58 (6.7%) were "upstaged" by IHC. In 6 of 58 patients (10.3%) who had IHC-only positive SLN, nodal metastases were found in the axillary dissection specimen. Conclusions: IHC resulted in upstaging of 6.7% of patients who had negative SLN on H&E staining. These patients had a 10.3% risk of residual axillary nodal metastases. However, the clinical significance of IHC-only positive SLN requires further study.

Original languageEnglish (US)
Pages (from-to)330-334
Number of pages5
JournalAmerican Journal of Surgery
Issue number4
StatePublished - 2001
Externally publishedYes


  • Breast cancer
  • Cytokeratin
  • Immunohistochemistry
  • Micrometastasis
  • Sentinel lymph node biopsy

ASJC Scopus subject areas

  • Surgery


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