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February 1990

Improved Detection of Metastases to Lymph Nodes and Estrogen Receptor Determination

Author Affiliations

From the Departments of Surgery (Dr Scanlon) and Pathology (Drs Sharon and Goldschmidt), Evanston (Ill) Hospital, and Northwestern University Medical School, Chicago, Ill. Mr Schurman is a research assistant at Evanston Hospital.

Arch Surg. 1990;125(2):179-182. doi:10.1001/archsurg.1990.01410140057010

• We present a new method for detection of micrometastases to axillary lymph nodes and estrogen receptor determination. Cellular suspensions from primary infiltrating ductal breast carcinoma or level I axillary lymph nodes of patients who underwent mastectomies were obtained, by loosely grinding fresh tumors or lymph nodes through a grid and then transferring the matrix to a slide using cytocentrifugation. Tumor samples were analyzed for estrogen receptor status using an immunocytochemical kit and compared with the dextran-coated charcoal method. Thirty-eight of 46 correlated (20 were estrogen positive, and 18 were estrogen negative). Seven of 46 were estrogen positive while results from the dextran-coated charcoal method were estrogen negative. One of 46 was estrogen negative, while the results from the dextran-coated charcoal method were estrogen positive. Lymph node slide preparations were stained to detect tumor cells using antikeratin monoclonal antibodies. Three of 8 node-negative patients were found to have micrometastases. Four of 15 node-positive patients had additional nodes with tumor. Our method combines the advantages of serial sectioning and immunohistochemical staining.

(Arch Surg. 1990;125:179-182)