Whole sentinel lymph node analysis by a molecular assay predicts axillary node status in breast cancer

• Published in: British journal of cancer Vol. 107; no. 8; pp. 1239 - 1243
• Main Authors: Ohi, Y, Umekita, Y, Sagara, Y, Rai, Y, Yotsumoto, D, Matsukata, A, Baba, S, Tamada, S, Matsuyama, Y, Ando, M, Sasaki, M, Tsuchimochi, S, Tanimoto, A
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 09-10-2012; Nature Publishing Group
• Subjects: 631/67/322; 692/699/67/1347; 692/700/139; Axilla - pathology; Biomedical and Life Sciences; Biomedicine; Biopsy; Breast cancer; Breast Neoplasms - genetics; Breast Neoplasms - pathology; Cancer Research; clinical-study; Cytokeratin; Drug Resistance; Epidemiology; Female; Hospitals; Humans; Keratin-19 - genetics; Lymph Nodes - pathology; Lymphatic Metastasis; Lymphatic system; Medical research; Metastasis; Middle Aged; Molecular Medicine; Nucleic Acid Amplification Techniques; Oncology; Pathology; Patients; Predictive Value of Tests; Reproducibility of Results; Retrospective Studies; RNA, Messenger; Sentinel Lymph Node Biopsy; Japan; whole sentinel lymph node; non-sentinel lymph node; breast cancer; one-step nucleic amplification assay
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2012.387

Background:
The one-step nucleic acid amplification (OSNA) assay is a rapid procedure for the detection of lymph node (LN) metastases using molecular biological techniques. The aim of this study was to assess the reliability of the whole sentinel lymph node (SLN) analysis by the OSNA assay as a predictor of non-SLN metastases.
Methods:
Consecutive 742 patients with breast cancer were enroled in the study. The association of non-SLN or ⩾4 LN metastases with clinicopathological variables was investigated using multivariate logistic analysis.
Results:
In total, 130 patients with a positive SLN who underwent complete axillary LN dissection were investigated. The frequency of non-SLN metastases in patients who were OSNA+ and ++ was 19.3% and 53.4%, respectively, and that in patients with ⩾4 LN metastases who were OSNA+ and ++ was 7.0% and 27.4%, respectively. The cytokeratin 19 (CK19) mRNA copy number (⩾5.0 × 10
3
; OSNA++) in the SLN was the most significant predictors of non-SLN metastases (
P
=0.003). The CK19 mRNA copy number (⩾1.0 × 10
5
) in the SLN was the only independent predictor of ⩾4 LN metastases (
P
=0.014).
Conclusion:
Whole SLN analysis using the OSNA assay could become a valuable method for predicting non-SLN and ⩾4 LN metastases.