Comparison of the Detection of Breast Carcinoma Metastases by Routine Histological Diagnosis and by Immunohistochemical Staining

The detection of metastases in 371 axillary lymph nodes by immunohistochemical staining and by routine histological examination was compared in the surgically removed tissue from 50 consecutive patients with breast carcinoma. The primary tumour and axillary lymph nodes were stained with three monoclonal antibodies directed against epitopes of the human milk fat globule (HMFG1; HMFG2; E29), and an anticytokeratin antibody (CAM 5.2), in a double-bridge immunoalkaline phosphatase staining technique. Metastases revealed by further sectioning through the tissue were identified before the immunohistological comparison. The use of immunohistochemical staining resulted in an increased detection of metastases in both infiltrating ductal carcinoma (13.1%) and infiltrating lobular carcinoma (37.5%), an overall increase of 17.3%. The follow-up data over a minimum period of 2 years is available for these patients.