Figure 1

A simple and standardized protocol, with slicing at three levels at 100-micron intervals and double staining with both hematoxylin-eosin and immunohistochemistry, that has allowed the pathologists in the authors' group to diagnose additional nodal disease with an increment of nearly two thirds compared with standard, single-section analysis of the lymph nodes stained with hematoxylin-eosin. (Adapted from Fortunato L, Amini M, Costarelli L, et al. A standardized sentinel lymph node enhanced pathology protocol (SEPP) in patients with breast cancer. J Surg Oncol 2007;96[6]:471; with permission.)