Topic Review and Opinion: The Significance of Extracapsular Axillary Lymph Node Extension by Metastatic Breast Cancer
Abstract
Topic Review and OpinionThe Significance of Extracapsular Axillary Lymph Node Extension by Metastatic Breast Cancer SAGE Publications, Inc.1995DOI: 10.1177/106689699500300110 Neal S. Goldstein M.D. Department of Anatomic Pathology, William Beaumont Hospital, Royal Oak, Michigan Reprint requests: Neal Goldstein, Department of Anatomic pathology, William Beaumont Hospital, 3601 West Thirteen Mile Road, Royal Oak, MI 48073-6769. Some radiation oncologists use the presence of extracapsular lymph node extension by tumor as a partial basis for deciding whether or not to irradiate the axillae of women with metastatic breast carcinomas. This is predicated on the belief that pathologists have standardized and reproducible criteria for extracapsular lymph node extension and that extracapsular lymph node extension by tumor is associated with increased axillary recurrence. Because this histologic parameter has not received attention in the recent pathology literature, the little literature that is available deserves at least a brief review. Five studies address this topic.'-' Descriptive criteria of extracapsular lymph node extension are provided in all five and pictorial examples are provided in four.I-3.5 1\vo show tumors extending several millimeters beyond the lymph node capsule, another 1-2 mm, and the last less than I mm beyond the capsule. Therefore, the minimal published criteria of extracapsular lymph