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

Breast Cancer Research and Treatment volume 131, pages 509–516 (2012)Cite this article

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.

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References

  1. Fleissig A, Fallowfield LJ, Langridge CI, Johnson L, Newcombe RG, Dixon JM, Kissin M, Mansel RE (2006) Post-operative arm morbidity and quality of life. Results of the ALMANAC randomised trial comparing sentinel node biopsy with standard axillary treatment in the management of patients with early breast cancer. Breast Cancer Res Treat 95:279–293

    PubMed  Article  Google Scholar 

  2. Lorand S, Lavoue V, Tas P, Foucher F, Mesbah H, Rouquette S, Bendavid C, Coue O, Poree P, Leveque J (2011) Intraoperative touch imprint cytology of axillary sentinel nodes for breast cancer: a series of 355 procedures. Breast 20:119–123

    PubMed  Article  Google Scholar 

  3. Fritzsche FR, Reineke T, Morawietz L, Kristiansen G, Dietel M, Fink D, Rageth C, Honegger C, Caduff R, Moch H, Varga Z (2010) Pathological processing techniques and final diagnosis of breast cancer sentinel lymph nodes. Ann Surg Oncol 17:2892–2898

    PubMed  Article  Google Scholar 

  4. Varga Z, Rageth C, Saurenmann E, Honegger C, von Orelli S, Fehr M, Fink D, Seifert B, Moch H, Caduff R (2008) Use of intraoperative stereomicroscopy for preventing loss of metastases during frozen sectioning of sentinel lymph nodes in breast cancer. Histopathology 52:597–604

    PubMed  Article  CAS  Google Scholar 

  5. Notomi T, Okayama H, Masubuchi H, Yonekama T, Watanabe K, Amino N, Hase T (2000) Loop-mediated isothermal amplification of DNA. Nucleic Acids Res 28(12):E63

    PubMed  Article  CAS  Google Scholar 

  6. Tsujimoto M, Nakabayashi K, Yoshidome K, Kaneko T, Iwase T, Akiyama F, Kato Y, Tsuda H, Ueda S, Sato K et al (2007) One-step nucleic acid amplification for intraoperative detection of lymph node metastasis in breast cancer patients. Clin Cancer Res 13:4807–4816

    PubMed  Article  CAS  Google Scholar 

  7. Schem C, Maass N, Bauerschlag DO, Carstensen MH, Loning T, Roder C, Batic O, Jonat W, Tiemann K (2009) One-step nucleic acid amplification-a molecular method for the detection of lymph node metastases in breast cancer patients; results of the German study group. Virchows Arch 454:203–210

    PubMed  Article  Google Scholar 

  8. Snook KL, Layer GT, Jackson PA, de Vries CS, Shousha S, Sinnett HD, Nigar E, Singhal H, Chia Y, Cunnick G et al (2011) Multicentre evaluation of intraoperative molecular analysis of sentinel lymph nodes in breast carcinoma. Br J Surg 98:527–534

    PubMed  Article  CAS  Google Scholar 

  9. Tamaki Y, Akiyama F, Iwase T, Kaneko T, Tsuda H, Sato K, Ueda S, Mano M, Masuda N, Takeda M et al (2009) Molecular detection of lymph node metastases in breast cancer patients: results of a multicenter trial using the one-step nucleic acid amplification assay. Clin Cancer Res 15:2879–2884

    PubMed  Article  CAS  Google Scholar 

  10. Visser M, Jiwa M, Horstman A, Brink AA, Pol RP, Van DP, Snijders PJ, Meijer CJ (2008) Intra-operative rapid diagnostic method based on CK19 mRNA expression for the detection of lymph node metastases in breast cancer. Int J Cancer 122:2562–2567

    PubMed  Article  CAS  Google Scholar 

  11. Le Frère-Belda MA, Bats AS, Gillaizeau F, Poulet B, Clough KB, Nos C, Peoc’h M, Seffert P, Bouteille C, Leroux A, Guillemin F, Blanc-Fournier C, Crouet H, Arnould L, Cuisenier J, Penault-Llorca F, Gimbergues P, Jacquemier J, Houvenaeghel G, Chatellier G, Lécuru F (2011) Diagnostic performance of one-step nucleic acid amplification for intraoperative sentinel node metastasis detection in breast cancer patients. Int J Cancer doi: 10.1002/ijc.26291. [Epub ahead of print]

  12. Schwartz GF, Giuliano AE, Veronesi U (2002) Proceedings of the consensus conference on the role of sentinel lymph node biopsy in carcinoma of the breast, April 19–22, 2001, Philadelphia, Pennsylvania. Cancer 94:2542–2551

    PubMed  Article  Google Scholar 

  13. Viale G, Maiorano E, Pruneri G, Mastropasqua MG, Valentini S, Galimberti V, Zurrida S, Maisonneuve P, Paganelli G, Mazzarol G (2005) Predicting the risk for additional axillary metastases in patients with breast carcinoma and positive sentinel lymph node biopsy. Ann Surg 241:319–325

    PubMed  Article  Google Scholar 

  14. Houvenaeghel G, Nos C, Mignotte H, Classe JM, Giard S, Rouanet P, Lorca FP, Jacquemier J, Bardou VJ (2006) Micrometastases in sentinel lymph node in a multicentric study: predictive factors of nonsentinel lymph node involvement–Groupe des Chirurgiens de la Federation des Centres de Lutte Contre le Cancer. J Clin Oncol 24:1814–1822

    PubMed  Article  Google Scholar 

  15. Weaver DL (2010) Pathology evaluation of sentinel lymph nodes in breast cancer: protocol recommendations and rationale. Mod Pathol 23(Suppl 2):S26–S32

    PubMed  Article  Google Scholar 

  16. Chu PG, Weiss LM (2002) Keratin expression in human tissues and neoplasms. Histopathology 40:403–439

    PubMed  Article  CAS  Google Scholar 

  17. Alvarenga CA, Paravidino PI, Alvarenga M, Dufloth R, Gomes M, Zeferino LC, Schmitt F (2011) Expression of CK19 in invasive breast carcinomas of special histological types: implications for the use of one-step nucleic acid amplification. J Clin Pathol 64:493–497

    PubMed  Article  Google Scholar 

  18. Andersson Y, Frisell J, Sylvan M, de BJ, Bergkvist L (2010) Breast cancer survival in relation to the metastatic tumor burden in axillary lymph nodes. J Clin Oncol 28:2868–2873

    PubMed  Article  Google Scholar 

  19. Weaver DL, Ashikaga T, Krag DN, Skelly JM, Anderson SJ, Harlow SP, Julian TB, Mamounas EP, Wolmark N (2011) Effect of occult metastases on survival in node-negative breast cancer. N Engl J Med 364:412–421

    PubMed  Article  CAS  Google Scholar 

  20. Cutress RI, McDowell A, Gabriel FG, Gill J, Jeffrey MJ, Agrawal A, Wise M, Raftery J, Cree IA, Yiangou C (2010) Observational and cost analysis of the implementation of breast cancer sentinel node intraoperative molecular diagnosis. J Clin Pathol 63:522–529

    PubMed  Article  CAS  Google Scholar 

  21. Guillen-Parédes MP, Carrasco-González L, Cháves-Benito A, Campillo-Soto A, Carrillo A, Aguayo-Albasini JL (2011) One-step nucleic acid amplification (OSNA) assay for sentinel lymph node metastases as an alternative to conventional postoperative histology in breast cancer: A cost-benefit analysis. Cir Esp 89(7):456–462

    PubMed  Article  Google Scholar 

  22. Giuliano AE, McCall L, Beitsch P, Whitworth PW, Blumencranz P, Leitch AM, Saha S, Hunt KK, Morrow M, Ballman K (2010) Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial. Ann Surg 252:426–432

    PubMed  Google Scholar 

  23. Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, Leitch AM, Saha S, McCall LM, Morrow M (2011) Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA 305:569–575

    PubMed  Article  CAS  Google Scholar 

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Acknowledgements

We thank Michelle Marty, Gwénaelle Duval, Stéphane Moiteaux for their technical assistance, and Odile Audrain for rewieving the literature. G. Pope has post-edited the English style.

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Authors and Affiliations

  1. Regional Mastology Center, Departement of Biology, Eugène Marquis Comprehensive Cancer Center, CS 44 229, Avenue de la Bataille Flandres Dunkerques, 35 042, Rennes Cedex, France

    Florence Godey, Gwenola Gandon & Véronique Quillien

  2. Regional Mastology Center, Departement of Surgical Oncology, Eugène Marquis Comprehensive Cancer Center, CS 44 229, Avenue de la Bataille Flandres Dunkerques, 35 042, Rennes Cedex, France

    Jean Leveque, Patrick Tas, Philippe Poree, Habiba Mesbah & Cécile Bendavid Athias

  3. Departement of Gynecology, CHU Anne de Bretagne, BP 90 347, 16 Bd de Bulgarie, 35 203, Rennes Cedex 2, France

    Jean Leveque & Vincent Lavoue

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  1. Florence Godey
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  2. Jean Leveque
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  3. Patrick Tas
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  4. Gwenola Gandon
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  5. Philippe Poree
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  7. Vincent Lavoue
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  9. Cécile Bendavid Athias
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Correspondence to Florence Godey.

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Godey, F., Leveque, J., Tas, P. et al. Sentinel lymph node analysis in breast cancer: contribution of one-step nucleic acid amplification (OSNA). Breast Cancer Res Treat 131, 509–516 (2012). https://doi.org/10.1007/s10549-011-1808-4

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  • DOI: https://doi.org/10.1007/s10549-011-1808-4

Keywords

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