Breast Cancer - Arab Medical Association Against Cancer

Prognostic Factors 205The presence of micrometastases is also linked to a higher risk of relapse, for ductal but notlobular type. Different works have proven that immunohistochemical staining could improvethe detection of micrométastases, but this is cost effective and time consuming for acomplete axillary dissection. Capsular invasion and rupture is related to the number of lymphnodes involved and has no prognostic value by itself, as a histiocytic reaction.Sentinel Node Biopsy (SLN)Even though it is not yet considered as a validated technique, it is today applied in firstintension by most of the working teams. To guarantee its credibility, it is necessary to adopt aparticular technique of histological analysis requiring multiple cut section levels and immunohisto-chemicalstaining. This latter, guarantees more frequent detection of metastasis,especially the small size ones, less than 2mm.The risk of invasion by tumor cells of the remaining part of the axillary lymph nodesincreases with the increase in number of metastatic sentinel nodes and the size of detectedmetastasis. However, even in case of presence of minimal lymphatic metastasis