While looking for something else this week, I found this article:

"Optimal Histopathologic Examination of the Sentinel Lymph Node
for Breast Carcinoma Staging"
Turner RR, Ollila DW, Stern S, Giulano AE
Am J Surg Pathol 1999 Mar;23(3):263-7

>From St. John's Health Center, Santa Monica CA

Their usual protocol was a FS at level 1, plus 2 levels on the paraffin,
separated by 40 um, and stained with H&E and cytokeratin IHC.

They studied 60 sentinel nodes (SN) from 42 patients that were
tumor-negative
on the FS and the two H&E paraffin levels. Of the 60 SN, 9 SN (8
patients)
showed micrometastases on cytokeratin IHC on the two paraffin levels.

Of the remaining 51 SN (34 patients), additional levels (3-10) were done
on the paraffin blocks, 40 um apart. Of these, only two (4%) SN from 
one (3%) patient had metastatic carcinoma cells in the further levels.

Their recommendation was that the SN have 2 levels of the paraffin
block,
stained with both H&E and cytokeratin IHC to optimize staging and
minimize
labor and cost of multiple step sections and IHC stains.

Hope this helps.

------------------

Peggy A. Wenk, HTL(ASCP)
William Beaumont Hospital
Royal Oak, MI 48073

Coni Forney wrote:
> 
> Help - looking for protocol for cutting sentinal nodes - what is everyone
> using as far as levels, etc. We are currently taking several levels at the
> beginning and then every 10 cuts until the block is exhausted. Is there a
> standard protocol or is it site specific? Please advise. Thanks,
> 
> Constance M. Forney MT HT(ASCP)
> Technical Supervisor, Histopathology
> USAF Medical Center
> Wright Patterson AFB, OH