Which techniques are used to identify micrometastases and ITCs in axillary lymph nodes of patients with breast cancer?

Updated: Mar 20, 2019
  • Author: Oudai Hassan, MD; Chief Editor: Chandandeep Nagi, MD  more...
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Protocols used to increase the likelihood of identifying micrometastases and ITCs vary widely from laboratory to laboratory. The techniques used include step sectioning at different intervals through the block and cytokeratin immunohistochemical stains. When interpreting immunohistochemical stains, correlation with H&E and morphologic features (particularly nuclear features) is needed. Only cytokeratin-positive tumor cells (morphologically identifiable as such by comparison with H&E, by cell size, and by nuclear morphology), not cytokeratin-positive cells, are reported as ITC. It is helpful to state how the lymph nodes were examined (eg, number of H&E levels, cytokeratin immunostain).

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