{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T05:16:07Z","timestamp":1770786967179,"version":"3.50.0"},"reference-count":74,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Background.<\/jats:italic>\n                    \u2014Axillary lymph node dissection for evaluation of the presence or absence of metastatic disease is the single most important prognostic factor for patients with newly diagnosed primary breast cancer. Recently, sentinel lymph node (SLN) biopsy is being investigated as an alternative to the evaluation of the entire axilla. We evaluated whether the application of multilevel sectioning and immunohistochemistry in SLNs will increase the accuracy of detection of metastatic deposits.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Methods.<\/jats:italic>\n                    \u2014Between October 1998 and July 1999, 38 patients with breast carcinoma (25 ductal, 5 lobular, 4 tubular, and 4 mixed ductal and lobular) underwent successful SLN biopsy followed by complete axillary node dissection. Sentinel lymph nodes were localized with a combination of isosulfan blue dye and radionuclide colloid injection. Frozen sections and permanent sections of SLNs were examined. All negative SLNs were examined for micrometastases by 3 additional hematoxylin-eosin (H&amp;E)-stained sections and immunohistochemistry with the cytokeratins AE1\/AE3.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results.<\/jats:italic>\n                    \u2014Sentinel lymph nodes were successfully identified surgically in 38 (93%) of 41 patients. There was a 97% correlation between the results of the frozen sections and the permanent H&amp;E-stained sections. Twelve (32%) of 38 patients showed evidence of metastatic disease in their SLN by routine H&amp;E staining. In 7 (58%) of 12 patients with positive nodes, the sentinel node was the only positive node. The 26 patients with negative SLN examination by H&amp;E were further analyzed for micrometastases; 5 (19%) were found to have metastatic deposits by immunohistochemistry. Of these patients, 2 were also converted to node positive by detection of micrometastatic disease by examination of the additional H&amp;E levels.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions.<\/jats:italic>\n                    \u2014Sentinel lymph nodes can be accurately identified in the axilla of breast cancer patients. Evaluation of SLNs provides reliable information representative of the status of the axilla in these patients. Immunohistochemistry and, to a lesser degree, detailed multilevel sectioning are able to further improve our ability to detect micrometastatic disease in SLNs of breast cancer patients.\n                  <\/jats:p>","DOI":"10.5858\/2000-124-1670-eoasln","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T20:11:58Z","timestamp":1611864718000},"page":"1670-1673","source":"Crossref","is-referenced-by-count":53,"title":["Evaluation of Axillary Sentinel Lymph Node Biopsy by Immunohistochemistry and Multilevel Sectioning in Patients With Breast Carcinoma"],"prefix":"10.5858","volume":"124","author":[{"given":"Lucy H.","family":"Liu","sequence":"first","affiliation":[{"name":"From the Departments of Pathology (Drs Liu, Siziopikou, and McClatchey) and Surgery (Dr Gabram), Loyola University Medical Center and Stritch School of Medicine, Maywood, Ill."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalliopi P.","family":"Siziopikou","sequence":"additional","affiliation":[{"name":"Reprints: Kalliopi P. Siziopikou, MD, PhD, Department of Pathology, Loyola University Medical Center, EMS Building, Suite 2240, 2160 S First Ave, Maywood, IL 60153."},{"name":"From the Departments of Pathology (Drs Liu, Siziopikou, and McClatchey) and Surgery (Dr Gabram), Loyola University Medical Center and Stritch School of Medicine, Maywood, Ill."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheryl","family":"Gabram","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology (Drs Liu, Siziopikou, and McClatchey) and Surgery (Dr Gabram), Loyola University Medical Center and Stritch School of Medicine, Maywood, Ill."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth D.","family":"McClatchey","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology (Drs Liu, Siziopikou, and McClatchey) and Surgery (Dr Gabram), Loyola University Medical Center and Stritch School of Medicine, Maywood, Ill."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3906","reference":[{"key":"i1543-2165-124-11-1670-b1","series-title":"Cancer","first-page":"1551","article-title":"Relationship of number of positive axillary nodes to the prognosis of patients with primary breast cancer.","volume":"52","author":"Fisher, B.","year":"1983","unstructured":"Fisher, B., M.Bauer, and D. 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R.","year":"1991","unstructured":"Harris, J. R. and S.Hellman. Natural history of breast cancer.In: Harris JR, Hellman S, Henderson IC, Kinne DW, eds. Breast Diseases. Philadelphia, Pa: JB Lippincott. 1991. 165\u2013206."},{"key":"i1543-2165-124-11-1670-b6","series-title":"Cancer","first-page":"2507","article-title":"Pathologic findings from the National Surgical Adjuvant Breast Project protocol B-06: 10-year pathologic and clinical prognostic discriminants.","volume":"71","author":"Fisher, E. R.","year":"1993","unstructured":"Fisher, E. R., S.Anderson, C.Redmond, and B.Fisher. Pathologic findings from the National Surgical Adjuvant Breast Project protocol B-06: 10-year pathologic and clinical prognostic discriminants.Cancer1993. 71:2507\u20132514."},{"key":"i1543-2165-124-11-1670-b7","series-title":"Breast J","first-page":"221","article-title":"Detection and significance of occult axillary metastatic disease in breast cancer patients.","volume":"5","author":"Siziopikou, K. 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P.","year":"1999","unstructured":"Siziopikou, K. P., S. J.Schnitt, J. L.Connolly, and D. F.Hayes. Detection and significance of occult axillary metastatic disease in breast cancer patients.Breast J1999. 5:221\u2013229."},{"key":"i1543-2165-124-11-1670-b8","series-title":"Arch Surg","first-page":"392","article-title":"Technical details of intraoperative lymphatic mapping for early stage melanoma.","volume":"127","author":"Morton, D.","year":"1992","unstructured":"Morton, D., D. R.Wen, and J. H.Wong. et al. Technical details of intraoperative lymphatic mapping for early stage melanoma.Arch Surg1992. 127:392."},{"key":"i1543-2165-124-11-1670-b9","series-title":"Surg Oncol","first-page":"335","article-title":"Surgical resection and radiolocalization of the sentinel node in breast cancer using a gamma probe.","volume":"2","author":"Krag, D. N.","year":"1993","unstructured":"Krag, D. N., D. L.Weaver, J. C.Alex, and J. T.Fairbank. Surgical resection and radiolocalization of the sentinel node in breast cancer using a gamma probe.Surg Oncol1993. 2:335."},{"key":"i1543-2165-124-11-1670-b10","series-title":"Ann Surg","first-page":"391","article-title":"Lymphatic mapping and sentinel lymphadenectomy for breast cancer.","volume":"220","author":"Giuliano, A. E.","year":"1994","unstructured":"Giuliano, A. E., D. M.Kirgen, and J. M.Guenther. Lymphatic mapping and sentinel lymphadenectomy for breast cancer.Ann Surg1994. 220:391."},{"key":"i1543-2165-124-11-1670-b11","series-title":"Ann Surg","first-page":"394","article-title":"Improved axillary staging of breast cancer with sentinel lymphadenectomy.","volume":"222","author":"Giuliano, A. E.","year":"1995","unstructured":"Giuliano, A. E., P.Dale, R. R.Turner, D. L.Morton, S. W.Evans, and D. L.Krasne. Improved axillary staging of breast cancer with sentinel lymphadenectomy.Ann Surg1995. 222:394\u2013401."},{"key":"i1543-2165-124-11-1670-b12","series-title":"JAMA","first-page":"1818","article-title":"Lymphatic mapping and sentinel node biopsy in the patient with breast cancer.","volume":"276","author":"Albertini, J. J.","year":"1996","unstructured":"Albertini, J. J., G. H.Lyman, and C.Cox. et al. Lymphatic mapping and sentinel node biopsy in the patient with breast cancer.JAMA1996. 276:1818."},{"key":"i1543-2165-124-11-1670-b13","series-title":"J Clin Oncol","first-page":"2345","article-title":"Sentinel lymphadenectomy in breast cancer.","volume":"15","author":"Giuliano, A. E.","year":"1997","unstructured":"Giuliano, A. E., R. C.Jones, M.Brennan, and R.Statman. 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