This study was performed to identify the cancer cells in lymph nodes taken from women stage IIa breast cancer using routine hematoxyline-eosin(HE) stains. Six hundred and thirty-four lymph nodes were taken from 42 cases of breast cancer. Among these, 31 cases were negative for lymph nodes metastasis and 1l were positive for lymph node metastasis. All 634 lymph nodes were immunostained. Eight of 11 patients(72.7%) who had positive lymph nodes had at least one or more nodes stained by anti-epithelial membrane antibody and 7 of ll patients(63.6%) who had positive nodes had at least one or more nodes stained by anti-cytokeratin(PAN-CK) anti-body. Of the 31 cases of negative lymph nodes, 2 cases of occult micrometastases were detected by immunohistochemical stains. One of the 2 cases was stained by only one monoclonal antibody In the follow up study(a mean of 59.9 months), there were no important prognostic factors for 5 year survival rates according to the following 3 categories: age( < 40 years vs. >=40 years), tumor size(< 2.0cm vs. >=2.0cm), and immunohistochemical stain. The presence of metastatic axillary lymph node was the most important prognostic factor for 5 year disease free survival(p=0.05). The immunohistochemical stain of the axillary lymph nodes was not significant for 5 year overall and disease free survival. One of the 2 patients who had negative axillary nodes by HE stain but positive nodes by immunohistochemical stains had a recurrence within 4 years and 11 months after mastectomy. Immunohistochemical stain for axillary lymph nodes of patients without lymph node metastases is a useful tool for detecting occult micrometastases, however, it is not helpful as a prognostic factor.
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