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Small axillary lymph node metastases from an invasive lobular carcinoma of the breast can be notoriously difficult to detect on routine haematoxylin and eosin (H&E) staining. Since August 2001, it has been our departmental policy to carry out immunohistochemistry using a broad spectrum antikeratin antibody (AE1/AE3; Dako Ltd, Ely, Cambridgeshire, UK) to ensure that micrometastases are not missed.
Between August 2001 and September 2002, 62 patients were coded as having invasive lobular cancer on our database. Twenty …