title: Relationship between histologic features of primary breast carcinomas and axillary lymph node micrometastases: Detection and prognostic significance.
abstract: The incidence and prognostic significance of micrometastases (Mic-Met) in axillary lymph nodes (LNs) is still controversial. We compared Mic-Met detection of invasive mammary carcinomas (IMCs) in axillary LNs using second review of hematoxylin and eosin (H&E)-stained slides and immunohistochemistry (IHC) relating them with features of the primary tumor, and determining their influence on overall survival (OS) and disease-free survival (DFS). We studied 188 cases of IMCs with no axillary metastases in the initial reports. The original H&E slides of LN were re-viewed and new sections were submitted for IHC using pancytokeratin (AE1/AE3). All primary breast tumors were re-viewed and classified according to Page et al (1998) and College of American Pathologists criteria (2000). Tumors were graded using the Nottingham grading system. Kaplan-Meier curves were used to evaluate OS and DFS of 147 patients. Mic-Met detection was correlated to histologic features of primary tumor (size, type, grade, lymphatic/blood vessel invasion). Mic-Met were detected in 26/188 cases (by IHC: 23/188, 12.2%; by H&E: 12/188, 6.4%). The re-view of H&E slides showed good specificity (98.2%), but low sensitivity (39.1%), when compared with IHC. There was no relationship between features of primary tumor and Mic-Met detection, including patients with lobular carcinomas or IMCs with lobular features. There was no statistical difference in OS and DFS of patients with and without Mic-Met, but patients with Mic-Met presented lower survival curves. In conclusion, there was no relationship between histologic features of primary tumor and presence of Mic-Met, nor between Mic-Met detection and patients survival.
authors.affiliation: Departamento de Anatomia Patológica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
authors.forename: Vanessa Fortes Zschaber
authors.initials: VF
authors.lastname: Marinho
authors.forename: Marcos Salomão
authors.initials: MS
authors.lastname: Zagury
authors.forename: Lidiane Gomes
authors.initials: LG
authors.lastname: Caldeira
authors.forename: Helenice
authors.initials: H
authors.lastname: Gobbi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000378:metabolism; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis
chemical_list: D007633:Keratins