Regional hyperplastic lymph nodes in breast cancer: the role of lymphocytes and nodal macrophages. An immunological study with a five-year follow-up.

Five stage I and stage II breast cancer patients with sinus histiocytosis in two or more enlarged regional lymph nodes were studied. Peripheral lymphocytes, serum, and nodal lymphocytes were tested in vitro for cytotoxicity against autologous normal and tumor cells. Nodal macrophages were incubated with autologous peripheral lymphocytes and these "activated" lymphocytes then were tested in vitro for cytotoxicity against autologous normal and tumor cells. Peripheral lymphocytes (L) were not cytotoxic to autologous tumor (T) cells at 25:1 L/T ratios. Nodal lymphocytes were specifically cytotoxic to autologous tumor cells. Macrophages from hyperplastic regional lymph nodes transferred tumor specific inmunity to peripheral lymphocytes. Macrophages from small, nonhyperplastic regional lymph nodes did not transfer tumor specific immunity. With the advent of adjuvant chemotherapy and its attack on systemic immunity, a quantitative, immunopathological classification of breast cancer patients is needed in order to properly select patients for further therapy.