Contribution of minute axillary lymph nodes to accurate staging for patients with breast cancer

摘要： <正> Background Axillary lymph node metastasis is a very important metastatic pathway in breast cancer and its accuratedetection is important for staging tumour and guiding therapy.However,neither the accuracy of routine detection of lymphnode in surgical specimens nor the significance of minute lymph node with metastases in breast cancer is clear.Amodified method for conveniently detecting minute lymph node in specimens of axillary dissections in patients with breastcancer was used to analyze their influence on staging breast cancer.Methods Lymph nodes in fresh,unfixed,specimens of axillary dissections from 127 cases of breast cancer weredetected routinely.Then the axillary fatty tissues were cut into 1 cm thick pieces,soaked in Carnoy's solution for 6 to 12hours,taken out and put on a glass plate.Minute lymph nodes were detected by light of bottom lamp and examined byroutine pathology.Results Lymph nodes(n=2483,19.6±8.0 per case)were found by routine method.A further 879 lymph nodes up to 6mm(781<3 mm,6.9±5.3 per case,increasing mean to 26.5±9.7)were found from the axillary tissues after soaking inCarnoy's solution.By detection of minute lymph nodes,the stages of lymph node metastasis in 7 cases were changedfrom pathological node(pN)stage pN_0 to pN_1 in 4 cases,from pN_1 to pN_2 in 2 and from pN_2 to pN_3 in 1.Conclusions The accurate staging of axillary lymph node metastasis can be obtained routinely with number of axillarylymph nodes in most cases of breast cancer.To avoid neglecting minute lymph nodes with metastases,small axillarynodes should be searched carefully in the cases of earlier breast cancer with no swollen axillary nodes.Treatment withCarnoy's solution can expediently detect minute axillary nodes and improve the accurate staging of lymph nodes inbreast cancer. （共4頁）