ABSTRACT

This study was planned to evaluate whether assessing five histological sections separated by 25μm detects significantly more tumor metastases in axillary lymph nodes.

The study was a retrospective study cmposed of 56 mastectomy specimens. An extra four levels were cut from all blocks containing nonmetastatic lymph nodes of each individual case. The original section was then counted as the first level. All the sections were then examined for the presence of tumor metastases within lymph nodes at all five levels.

Twenty seven N0, 10 N1, 10 N2 and 9 N3 cases were examined. Three hundred and twelve paraffin blocks containing nonmetastatic lymph nodes were cut, resulting in an extra 1248 sections, and eight hundred and forty two lymph nodes were examined. Thirteen extra metastases were discovered in nodes at new levels. One of these extra metastases occurred in newly appearing lymph nodes that had not been present in the level 1. None of the cases in which extra lymph node metastases were changed in respect to the tumor stage.

Although extra metastases detected in this study did not increase the stages, histopathologic evaluation with multiple level sections may provide more significant prognostic knowledge compared to evaluation with one level section. But concerning the labour intensity and cost effectivity, the benefit that would be obtained from that procedure may be controversial.