Intraoperative pathologic evaluation of the sentinel lymph node (SLN) may guide immediate (synchronous) completion axillary lymph node dissection (ALND) for up to two-thirds of patients with nodal disease for breast cancer. The false-negative rates average one-third of cases, and one must be aware of false-positive results as this would result in unnecessary and morbid completion ALND. Currently, the use of immunohistochemistry (IHC) is controversial. There is no question that cytokeratin staining improves the sensitivity; however, there is no evidence that any of these "positive" cells are clinically significant and warrant therapy. Prospective randomized trials will be necessary to confirm or debunk the hypothesis that "sub- micrometastatic" disease has clinical significance.
|Original language||English (US)|
|Number of pages||6|
|State||Published - Dec 1 2004|
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