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Occult metastases were detected in 41 patients (12 per cent). Although most of these were micrometastatic (&amp;lt; 2 mm in diameter), larger or diffuse deposits were found in ten patients. Blind assessment of repeat haematoxylin and eosin stained sections detected metastases in ten of the 41 patients with occult metastases. After a median follow-up of 79 months, patients with occult metastases had a shorter time to disease recurrence (P &amp;lt; 0.05) but not to death. After adjustment for other prognostic factors, the presence of occult metastases in two or more nodes was the most significant predictor of both disease recurrence (P &amp;lt; 0.01) and death (P &amp;lt; 0.01). When the ten patients with positive haematoxylin and eosin sections were excluded from the analysis, the presence of occult metastases in two or more nodes was still associated with a reduced disease-free interval (P &amp;lt; 0.05) and survival (P &amp;lt; 0.05). Lymph node immunohistochemistry is a simple technique affording more accurate definition of nodal involvement than conventional methods.<\/jats:p>","DOI":"10.1002\/bjs.1800800417","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T17:49:19Z","timestamp":1172944159000},"page":"459-463","source":"Crossref","is-referenced-by-count":188,"title":["Detection and significance of occult metastases in node-negative breast cancer"],"prefix":"10.1093","volume":"80","author":[{"given":"P J","family":"Hainsworth","sequence":"first","affiliation":[{"name":"University Department of Surgery, St Vincent's Hospital , Victoria,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J J","family":"Tjandra","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, St Vincent's Hospital , Victoria,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R G","family":"Stillwell","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Melbourne ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Machet","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Melbourne ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M A","family":"Henderson","sequence":"additional","affiliation":[{"name":"University Department of Surgery, St Vincent's Hospital , Victoria,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G C","family":"Rennie","sequence":"additional","affiliation":[{"name":"University Department of Surgery, St Vincent's Hospital , Victoria,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I F C","family":"McKenzie","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, St Vincent's Hospital , Victoria,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R C","family":"Bennett","sequence":"additional","affiliation":[{"name":"University Department of Surgery, St Vincent's Hospital , Victoria,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1993,4,1]]},"reference":[{"key":"2024092812262345000_bib1","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1002\/1097-0142(197803)41:3<1170::AID-CNCR2820410355>3.0.CO;2-I","article-title":"Patterns of relapse and survival following radical mastectomy","volume":"41","author":"Valagussa","year":"1978","journal-title":"Cancer"},{"key":"2024092812262345000_bib2","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1002\/1097-0142(19890101)63:1<181::AID-CNCR2820630129>3.0.CO;2-H","article-title":"Relation of tumor size, lymph node status, and survival in 24 740 breast cancer cases","volume":"63","author":"Carter","year":"1989","journal-title":"Cancer"},{"key":"2024092812262345000_bib3","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1056\/NEJM198902233200801","article-title":"A randomized clinical trial evaluating sequential methotrexate and fluorouracil in the treatment of patients with node-negative breast cancer who have estrogen-receptor-negative tumors","volume":"320","author":"Fisher","year":"1989","journal-title":"N Engl J Med"},{"key":"2024092812262345000_bib4","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1056\/NEJM198902233200802","article-title":"A randomized clinical trial evaluating tamoxifen in the treatment of patients with node-negative breast cancer who have estrogen-receptor-positive tumors","volume":"320","author":"Fisher","year":"1989","journal-title":"N Engl J Med"},{"key":"2024092812262345000_bib5","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1093\/jnci\/80.8.550","article-title":"Treatment alert issued for node-negative breast cancer","volume":"80","year":"1988","journal-title":"J Natl Cancer Inst"},{"key":"2024092812262345000_bib6","doi-asserted-by":"crossref","first-page":"2025","DOI":"10.1002\/1097-0142(197810)42:4<2025::AID-CNCR2820420452>3.0.CO;2-J","article-title":"Detection and significance of occult axillary node metastases in patients with invasive breast cancer","volume":"42","author":"Fisher","year":"1978","journal-title":"Cancer"},{"key":"2024092812262345000_bib7","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1002\/1097-0142(196111\/12)14:6<1266::AID-CNCR2820140617>3.0.CO;2-9","article-title":"Significance of occult metastases. 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