Sentinel Lymph Node Metastasis in Breast Cancer: The First Libyan Report with Hormonal Profiling and International Comparison

• Wesam Elsaghayer

  Department of Pathology, Alrazi University, Misrata, Libya

  Author

  https://orcid.org/0000-0002-1584-624X (unauthenticated)

• Wafaa Babh

  Department of Pathology, Alrazi University, Misrata, Libya

  Author

  https://orcid.org/0000-0002-1584-624X (unauthenticated)

• Ali Shagan

  Department of Surgery, Misurata University, Misrata, Libya

  Author

  https://orcid.org/0009-0003-2628-4582 (unauthenticated)

• Misbah Elfagih

  Department of Surgery, Alhelal University Hospital, Misrata, Libya

  Author

  https://orcid.org/0009-0005-8941-3155 (unauthenticated)

• Esraa Obida

  Department of Pathology, Alhelal University Hospital, Misrata, Libya

  Author

  https://orcid.org/0009-0002-0485-6810 (unauthenticated)

• Ebrahim Elmahjoubi

  Department of Pathology, Alzuhor University Hospital, Misrata, Libya

  Author

  https://orcid.org/0009-0008-1201-7455 (unauthenticated)

• Mohamed Bashagha

  Department of Radiology, Alhelal University Hospital, Misrata, Libya

  Author

  https://orcid.org/0009-0002-4641-3436 (unauthenticated)

• Mohamed Elfagieh

  Faculty of Medicine, Alrazi University, Misrata, Libya

  Author

  https://orcid.org/0000-0002-1148-9767 (unauthenticated)

Sentinel lymph node biopsy (SLNB) has become the gold standard for axillary staging in early-stage breast cancer, significantly reducing the morbidity associated with full axillary lymph node dissection. This study represents the first systematic evaluation of SLNB in a Libyan patient population, with integration of multimodal pathological assessment and hormonal profiling. Twenty women with histologically confirmed invasive breast carcinoma underwent SLNB at Alhelal and Alzuhor University Hospitals between 2023 and 2025. Intraoperative touch imprint cytology, hematoxylin and eosin staining, and pancytokeratin immunohistochemistry were performed to detect nodal metastasis. SLN metastasis was observed in four patients (20%), with macrometastases identified in three and micrometastasis in one case—detected only by immunohistochemistry. Hormonal receptor analysis showed heterogeneity, with strong ER/PR positivity in the micrometastatic case. These findings underscore the essential role of immunohistochemistry in nodal staging and align with regional and international data.

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