Correlation between molecular metastases in sentinel lymph nodes of breast cancer patients and St Gallen risk category.
OBJECTIVE
To evaluate the clinical significance of tumour metastases detected using real-time reverse transcription-PCR (RT-PCR) in sentinel lymph nodes (SLN) of breast cancer patients.


METHODS
Sixty-seven patients with T1-T2 primary breast cancer were included in a prospective study. SLN were analysed for the presence of metastatic tumour cells using standard histopathology staining, immunochemistry (IHC) and multimarker real-time RT-PCR assay for mammaglobin (MMG), carcinoembryonic antigen (CEA) and cytokeratin-19 (CK19) mRNA expression. Correlations between molecular metastases and traditional clinicopathological prognostic factors, including St Gallen risk categories were studied.


RESULTS
Of the 67 patients, 15 (22.3%) had one or more pathology-positive SLN. Five (9.6%) pathology-negative SLN were positive by IHC and 19 (36.5%) by RT-PCR. Of note, RT-PCR analysis was also positive in all cases with pathology- or IHC-positive SLN. MMG was the most informative tumour marker in the panel. Molecularly detected metastases were significantly associated with intermediate St Gallen risk category (p=0.023).


CONCLUSIONS
Molecular staging of SLN using real-time RT-PCR for early breast cancer could serve as a useful complement to standard clinicopathological risk factors. Studies with long-term follow-up are necessary to define the impact of molecular metastases on disease free survival and overall survival.
Gimbergues
P
P
Department of Surgery, Centre Jean Perrin, Clermont-Ferrand, France.
Dauplat
M M
MM
Cayre
A
A
Durando
X
X
Le Bouedec
G
G
Finat-Duclos
F
F
Portefaix
G
G
Kwiatkowski
F
F
Dauplat
J
J
Penault-Llorca
F
F
Tchirkov
A
A
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D001943:Breast Neoplasms / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D002272:Carcinoembryonic Antigen / Q000235:genetics* / Q000378:metabolism; D018270:Carcinoma, Ductal, Breast / Q000235:genetics* / Q000378:metabolism / Q000556:secondary; D005260:Female; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D053539:Keratin-19 / Q000235:genetics* / Q000378:metabolism; D008207:Lymphatic Metastasis; D060785:Mammaglobin A; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000235:genetics* / Q000378:metabolism; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012334:RNA, Neoplasm / Q000235:genetics*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D014598:Uteroglobin / Q000235:genetics* / Q000378:metabolism
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D053539:Keratin-19; D060785:Mammaglobin A; D009363:Neoplasm Proteins; D012334:RNA, Neoplasm; C556448:SCGB2A2 protein, human; D014598:Uteroglobin