Breast cancer metastasis burden in sentinel nodes analysed using one-step nucleic acid amplification predicts axillary nodal status. Issue 5 (October 2015)

• Record Type: Journal Article
• Authors: Milner, Thomas D.; de Lusignan, Simon; Jones, Simon; Jackson, Peter A.; Layer, Graham T.; Kissin, Mark W.; Irvine, Tracey E.
• Is Part Of: Breast. Volume 24:Issue 5(2015)
• Page Start: 568
• Page End: 575
• Publication Date: 2015-10
• Subjects: Breast -- Diseases -- Periodicals; Breast -- Tumors -- Periodicals; Breast -- Periodicals; Electronic journals; Periodicals; 616
• DOI: 10.1016/j.breast.2015.05.004
• Languages: English
• ISSNs: 0960-9776

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Background</title> <p id="abspara0010">In breast cancer patients undergoing sentinel lymph node biopsy (SLNB) analysis using one-step nucleic acid amplification (OSNA), clarity is required as to the risk factors for non-sentinel lymph node (NSLN) involvement upon axillary lymph node dissection (ALND). This study aims to identify these factors, including categorising by extent of sentinel node positivity: solitary positive node (solitary), multiple nodes with some positive (multiple incomplete positive), or multiple nodes all of which are positive (multiple all positive).</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">We conducted a cohort study using prospectively collected data on 856 SLNBs analysed using OSNA, from patients with cT<sub>1-3</sub> clinically node-negative invasive breast cancer. ALND was performed for 289 positive SLNBs.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">NSLN metastases were identified in 73 (25.3%) ALNDs. Significant factors for NSLN involvement on multivariate analysis were: SLNB macrometastases (cytokeratin-19 mRNA count >5000 copies/μl) (adj.OR = 3.01; 95% CI, 1.61–5.66; p = 0.0006), multiple all positive vs. multiple incomplete positive SLNB (adj.OR = 2.92; 95% CI, 1.38–6.19; p = 0.0050), and undergoing mastectomy (adj.OR = 1.89; 95% CI, 1.00–3.55; p = 0.0486). Amongst multiple incomplete positive SLNBs, an 8.8% NSLN risk was identified when only micrometastases were present.</p> </sec> <sec> <title id="sectitle0030">Conclusion</title> <p id="abspara0025">Extent of sentinel lymph node positivity measured using OSNA predicts NSLN metastasis risk, aiding decisions surrounding axillary treatment.</p> </sec> </abstract>