Immunohistochemical Expression of Sentinel Lymph Nodes in Early Breast Cancer

Purpose : Sentinel lymph node (SLN) biopsy allows to identify the first lymph node into which a primary tumor drains.In breast cancer, identification of tumor cells in SLNs is one of the strong predictor of disease-free and overall survival for breast cancer patients.Its immunologic nature has been identified or established, and would provide us useful prognostic or predictable information on clinical outcome.Meterial and Methods : We performed immunohistochemical analysis of 149 SLN from 41 early breast cancers (T1/T2 and N0) between 2000 and 2003 at OOO University for 5 years.They had followed to determine immunoprofile alterations of CD4 helper, CD8 cytotoxic T cell and CD1a dendritic cell population whether they can predict distant metastasis or disease-free survival.Classical prognostic factors-tumor size, pathologic diagnosis, histological grade and nuclear grade were compared.Results : Immunohistocheminal expression of SLN appear independent of ER and PR, C-erbB2.Immunoprofile changes and clinical manifestation represent independent processes.Although more patients were alive at the 5year time point in the group with higher CD4 helper, CD8 cytotoxic T cell and CD1a dendritic cell population, this failed to reach statistical significance at the p= 0.05 level.The larger the tumor size is, the more the expression of CD1a, CD8 in SLN is increased(p-value =0.01/0.03). Conclusion :The expression of CD1 and CD8 correlatated primary tumor size of breast cancer.These finding demomstrate that immune-activity of primary tumor influence tumor-draining lymph node.Analysis for long term follow-up post surgery is required to investigate the association further.