IMMUNOHISTOCHEMICAL DETECTION AND SIGNIFICANCE OF AXILLARY LYMPH-NODEMICROMETASTASES IN BREAST-CARCINOMA - A STUDY OF 97 CASES

Paraffin blocks of all axillary lymph nodes from 97 patients with an i nitial histologic diagnosis of infiltrating ductal carcinoma and negat ive axillary nodes were recut and stained with two monoclonal antibodi es, AE/AE3 (antikeratin) and DF3 (developed against breast cancer cell s and reactive with a glycoprotein tumor-associated antigen). Immunohi stochemical staining detected occult micrometastases in 20 patients (2 0.6%). No patient had more than three lymph nodes involved by tumor. R eview of the original hematoxylin and eosin-stained sections revealed that foci of tumor were initially overlooked in nine of these cases (9 .3%). In the remaining 11 cases (11.3%) the metastatic foci were encou ntered in the process of recutting the paraffin blocks for immunohisto chemical studies. AE1/AE3 proved to be the more effective of the two a ntibodies in staining micrometastases. After a mean follow-up period o f 5.7 years, no significant decrease in survival or increase in tumor recurrence was detected for patients with occult micrometastases as co mpared to those patients without micrometastases.