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To:Coni Forney <conif@MEDCENOA.WPAFB.AF.MIL>
Date:Tue, 27 Jul 1999 21:01:53 -0400
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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
on the FS and the two H&E paraffin levels. Of the 60 SN, 9 SN (8
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
stained with both H&E and cytokeratin IHC to optimize staging and
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

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