It is necessary to make deep cuts (at least 3) on each. All macro and micro metastases are detected. In a standard analysis, the different sections used make it possible to examine the sentinel lymph nodes perfectly, without omitting the minimal attacks or even isolated cells. There are some rules to follow that demonstrate how an extemporaneous examination can be arbitrary. Standard Analysis Techniques for the Ganglion Examination in Classical Pathology: ( 13) But, fortunately, there are recommendations and guidelines. 2013: 20 years later, there is still no standardized and universally accepted protocol for anatomo-pathology analysis of the sentinel node.1993: The sentinel node technique was applied to breast cancer.1992: The sentinel node technique was applied to melanoma:.Cabanas to evaluate nodal extension in penile cancers. 1977: The sentinel node technique was developed by R.M.The examination of sentinel nodes was first performed in other types of cancer, before being applied to breast cancer. Surgery has always used minimally invasive techniques in order to limit associated morbidities and facilitate post-operative surgical recovery. A Brief History of Sentinel Node Examination Results: All macroscopic and micro metastases are detected.Imperative: cut the ganglion every 2 mm, either vertically (small ganglion ≤ 4 mm) or transversely (ganglion> 4 mm). Isolated tumor cells or clusters ≤ 0.2 mm are often only detected by immunohistochemistry. Aims: detect macro metastases (>2 mm), micro metastases (0.2–2 mm).Standard Histological Analysis of the Sentinel Node Analysis of the Sentinel Node Ganglion Have Revolutionized Breast Cancer Surgery The present article provides a review of the current literature, and discusses the advantages and disadvantages of examination during surgery of the sentinel node ( 7– 12).
Two techniques are currently available: standard and advanced. The purpose of the present article is to demonstrate how and why through a review of the current literature. Only the laboratory examination reassures the results. Sections are conditioning this examination and many pathologists and many pathologists don't want to take this responsibility. Oftentimes, further examination in the laboratory is necessary to obtain and validate reliable results. The sensitivity of this technique is dependent on the sections obtained, and interpretation can be challenging for pathologists. The examination of the sentinel node during surgery remains arbitrary as micro-metastases cannot be detected. Before performing axillary clearing, evidence of metastatic invasion of at least three lymph nodes is recommended. Examination of the sentinel lymph node has become the gold standard. The study of lymph nodes has a prognostic value and guides decision making for further treatment ( 3– 6). One such example of this is the disappearance of great axillary curage. In recent years the management of breast cancer has changed considerably. Approximately 40% of breast cancers metastasize to axillary lymph nodes and metastatic extension depends on disease stage. The sentinel lymph node advantageously replaces axillary dissection as a staging method in breast cancer T1 and T2 ( 2). If no tumor cells are identified in the sentinel lymph node ganglion by histological examination, the other lymph nodes are also negative for the presence of tumor cells in 99% of cases.
The presence of tumor cells can be identified in the lymph node when metastasis has occurred from the primary cancer site into the lymph node ( 1) If the sentinel lymph node ganglion is negative for the presence of tumor cells at the time of histological examination, the other lymph nodes are also negative in 99% of cases.
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