[Histonet] RE: Histonet Digest, Vol 128, Issue 10

[Terri Braud]

Yep, we're with you, Richard.  We've stopped doing cytokeratins on
sentinel node in breast ca cases, except lobular ca cases.
Terri
Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Holy Redeemer Hospital Laboratory
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3676
Fax: 215-938-3874

   3. RE: Cytokeratin AE1/AE3 (Cartun, Richard)
   
Message: 3
Date: Fri, 11 Jul 2014 16:08:56 +0000
From: "Cartun, Richard" <Richard.Cartun <@t> hhchealth.org>
Subject: [Histonet] RE: Cytokeratin AE1/AE3
Reference:  Weaver DL, et al.:  Effect of occult metastases on survival
in node-negative breast cancer.  NEJM 2011;364:412-421.  A study funded
by the National Cancer Institute (Clinical Trials).

Conclusion - "These data do not indicate a clinical benefit of
additional evaluation, including immunohistochemical analysis, of
initially negative sentinel nodes in patients with breast cancer.

Also, from an NSABP study:  Role of IHC in invasive lobular carcinoma -
Although routine IHC staining with cytokeratin is not indicated for most
breast cancers, it can be helpful for examination of the sentinel nodes
in patients with invasive lobular carcinoma since the morphology of
lobular cancer can be difficult to detect on H&E of axillary lymph nodes
[91,92]. In general, IHC should be used to definitively diagnose an area
that is suspicious for, but not diagnostic of, lymph node metastases on
H&E rather than as a routine method of evaluating nodes in cases of
invasive lobular cancer.

I believe most major cancer centers have stopped doing cytokeratin IHC
on sentinel nodes for most breast cancer specimens.  I know that we
have.

Richard

Richard W. Cartun, MS, PhD
Director, Histology & Immunopathology

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