Sampling of sentinel lymph nodes: a simulation study

OBJECTIVE: To analyze the effects of various slicing schemes on the detection of metastases in lymph nodes. STUDY DESIGN: Use of an advanced computer simulation tool. RESULTS: Bisectioning along the longitudinal axis is an inadequate approach. Slicing ellipsoid lymph nodes along their longitudinal axis also results in a lower rate of detecting metastases since metastatic deposits have a predilection to localize subcapsularly. CONCLUSION: Ellipsoid lymph nodes must be sliced perpendicular to the longest axis to increase the rate of detecting metastases.