Immune response profile of primary tumour, sentinel and non-sentinel axillary lymph nodes related to metastasis in breast cancer: an immunohistochemical point of view

  • Albert Gibert-Ramos
  • Carlos LópezEmail author
  • Ramon Bosch
  • Laia Fontoura
  • Gloria Bueno
  • Marcial García-Rojo
  • Marta Berenguer
  • Marylène Lejeune


Approximately 1.67 million new cases of breast cancer (BC) are diagnosed annually, and patient survival significantly decreases when the disease metastasizes. The axillary lymph nodes (ALNs) are the main doorway for BC tumoral cell escape, through which cells can disseminate to distant organs. The immune response, which principally develops in the lymph nodes, is linked to cancer progression, and its efficacy at controlling tumoral growth is compromised during the disease. Immunohistochemistry (IHC) is one of the most widely used research techniques for studying the immune response. It allows the measurement of the expression of particular markers related to the immune populations. This review focuses on the role of the immune populations in the primary tumour in the locoregional metastasis of the ALN, and the relationship of the immune response in these regions to distant metastasis. We considered only studies of immune cells using IHC techniques. In particular, lymphocytes, macrophages and dendritic cells all play important roles in BC and have been extensively studied. Although further research is needed, there is much evidence of their role in the invasion of the ALN and distant organs. Their association with tumoral growth or protection has not yet been demonstrated decisively and is very likely to be determined by a combination of factors. Moreover, even though IHC is a widely used technique in cancer diagnosis and research, there is still room for improvement, since its quantification needs to be properly standardized.


Breast cancer Immune response Tumoral microenvironment Immunohistochemistry Lymphocytes Macrophages Dendritic cells 



This work was funded by projects PI11/0488 and PI13/02501 of the Institute of Health Carlos III, which is the main public research body that funds, manages and carries out biomedical research in Spain, and co-funded with European Union ERDF funds (European Regional Development Fund). It was also supported by the Project AIDPATH FP7-PEOPLE Project ID: 612471.

Compliance with ethical standard

Conflict of interest

The authors declare that they have no conflict of interest.


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Authors and Affiliations

  1. 1.Grup de Recerca en Patologia Oncològica i Bioinformàtica, Molecular Biology and Research SectionHospital de Tortosa Verge de la Cinta, IISPV, URVTortosaSpain
  2. 2.VISILABUniversidad de Castilla-La ManchaCiudad RealSpain
  3. 3.Department of PathologyHospital Universitario Puerta del MarCádizSpain
  4. 4.Knowledge Management DepartmentHospital de Tortosa Verge de la Cinta, ICS, IISPVTortosaSpain

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