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==Sentinel lymph node biopsy== | ==Sentinel lymph node biopsy== | ||
* | ===General=== | ||
*Used for staging, positive LNs = poorer prognosis. | |||
Notes: | |||
*There is '''no''' mortality benefit from axillary lymph node dissection - even in the setting of positive sentinel lymph nodes.<ref>{{cite journal |author=Giuliano AE, Hunt KK, Ballman KV, ''et al.'' |title=Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial |journal=JAMA |volume=305 |issue=6 |pages=569–75 |year=2011 |month=February |pmid=21304082 |doi=10.1001/jama.2011.90 |url=}}</ref> | |||
===Microscopic=== | |||
Features: | |||
*Atypical cells. | |||
**Nuclear changes of malignancy: | |||
***Nuclear enlargement + variation in size. | |||
***Variation in shape. | |||
***Hyperchromasia and variation in staining. | |||
**Usually in the subcapsular sinuses. | |||
Pitfalls: | Pitfalls: | ||
*Naevus cell rests.<ref>URL: [http://www.breastpathology.info/Case_of_the_month/2007/COTM_1107%20discussion.html http://www.breastpathology.info/Case_of_the_month/2007/COTM_1107%20discussion.html]. Accessed on: 28 November 2010.</ref> | *Naevus cell rests.<ref>URL: [http://www.breastpathology.info/Case_of_the_month/2007/COTM_1107%20discussion.html http://www.breastpathology.info/Case_of_the_month/2007/COTM_1107%20discussion.html]. Accessed on: 28 November 2010.</ref> | ||
===IHC=== | |||
Some hospitals use: | |||
*CAM5.2 (LMWK) - to look for isolated tumour cells and small lymph node metstases. | |||
==See also== | ==See also== |
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