Breast Cancer Research and Treatment

, Volume 131, Issue 2, pp 509–516

Sentinel lymph node analysis in breast cancer: contribution of one-step nucleic acid amplification (OSNA)

  • Florence Godey
  • Jean Leveque
  • Patrick Tas
  • Gwenola Gandon
  • Philippe Poree
  • Habiba Mesbah
  • Vincent Lavoue
  • Véronique Quillien
  • Cécile Bendavid Athias
Clinical trial

Abstract

One-step nucleic acid amplification (OSNA, Sysmex, Kobe, Japan) offers an excellent opportunity for accurate exhaustive sentinel lymph node (SLN) examination in breast cancer patients. Calibrated with conventional postoperative histology, this molecular technique yields comparable results intraoperatively, expressed as micrometastasis, macrometastasis or no metastasis depending on the CK19 mRNA copy number amplified in SLN lysates. We applied OSNA to detect metastasis in 810 SLNs from 367 patients with early stage breast cancer. We compared the rate of OSNA-positive SLNs in patients with invasive breast cancer (< 2 cm) versus the rate observed in a historical cohort using conventional histological examination of SLNs. No significant difference was observed, the OSNA assay was positive in 24.4% of patients, compared with positive histology in 24.8% in the historical cohort if including patients with isolated tumour cell (ITC) and in 23.4% excluding them. Opportunities for optimised patient management using OSNA are discussed: intraoperative detection of OSNA-positive SLNs enables axillary lymph node dissection (ALND) during the same procedure; standard OSNA techniques enable the establishment of homogeneous groups based on examination of whole SLNs for valid comparisons between different centres.

Keywords

Breast cancer Sentinel lymph node biopsy Molecular analysis Axillary lymph node dissection 

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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • Florence Godey
    • 1
  • Jean Leveque
    • 2
    • 3
  • Patrick Tas
    • 2
  • Gwenola Gandon
    • 1
  • Philippe Poree
    • 2
  • Habiba Mesbah
    • 2
  • Vincent Lavoue
    • 3
  • Véronique Quillien
    • 1
  • Cécile Bendavid Athias
    • 2
  1. 1.Regional Mastology Center, Departement of BiologyEugène Marquis Comprehensive Cancer CenterRennes CedexFrance
  2. 2.Regional Mastology Center, Departement of Surgical OncologyEugène Marquis Comprehensive Cancer CenterRennes CedexFrance
  3. 3.Departement of GynecologyCHU Anne de BretagneRennes Cedex 2France

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