Current Breast Cancer Reports

, Volume 4, Issue 2, pp 89–95

How Much is Enough? Pathologic Evaluation of Sentinel Lymph Nodes

Local-Regional Evaluation and Therapy (KK Hunt, Section Editor)

DOI: 10.1007/s12609-012-0073-9

Cite this article as:
Cserni, G. Curr Breast Cancer Rep (2012) 4: 89. doi:10.1007/s12609-012-0073-9


It is well accepted that detailed analysis of sentinel lymph nodes (SLNs) may upstage breast cancer, but generally involves the identification of low-volume metastases (including isolated tumor cells and clusters). Although several guidelines recommend therapeutic interventions for micrometastases, there is also evidence supporting therapeutic interventions only for macrometastases. There is also evidence in support of means of regional disease control other than axillary lymph node dissection (ALND). The pathologic evaluation of SLNs should consider the clinical setting. Intraoperative assessment is indicated only if ALND is an immediate interventional option for SLN positivity. Generally, hematoxylin and eosin-stained sections taken at 2-mm step intervals are sufficient to disclose macrometastases, but if micrometastases are also considered in further treatment planning, smaller intervals and immunohistochemistry as well as quantitative molecular methods may also be considered.


Breast cancerSentinel lymph nodesMacrometastasisMicrometastasisIsolated tumor cellsIntraoperativeFrozen sectionsImprint cytologyOne-step nucleic acid amplificationQuantitative real time reverse transcription polymerase chain reactionAxillary lymph node dissection

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of PathologyUniversity of Szeged, Faculty of MedicineSzegedHungary
  2. 2.Department of PathologyBács-Kiskun County Teaching HospitalKecskemétHungary