title: Scientific Impact Recognition Award. Sentinel node staging for breast cancer: intraoperative molecular pathology overcomes conventional histologic sampling errors.
abstract: BACKGROUND
  When sentinel node dissection reveals breast cancer metastasis, completion axillary lymph node dissection is ideally performed during the same operation. Intraoperative histologic techniques have low and variable sensitivity. A new intraoperative molecular assay (GeneSearch BLN Assay; Veridex, LLC, Warren, NJ) was evaluated to determine its efficiency in identifying significant sentinel lymph node metastases (>.2 mm).
  
  
  METHODS
  Positive or negative BLN Assay results generated from fresh 2-mm node slabs were compared with results from conventional histologic evaluation of adjacent fixed tissue slabs.
  
  
  RESULTS
  In a prospective study of 416 patients at 11 clinical sites, the assay detected 98% of metastases >2 mm and 88% of metastasis greater >.2 mm, results superior to frozen section. Micrometastases were less frequently detected (57%) and assay positive results in nodes found negative by histology were rare (4%).
  
  
  CONCLUSIONS
  The BLN Assay is properly calibrated for use as a stand alone intraoperative molecular test.
authors.affiliation: Breast Health Services, Morton Plant Mease Health Care, 303 Pinellas St, Ste. 310, Clearwater, FL 33756, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Blumencranz
authors.forename: Pat W
authors.initials: PW
authors.lastname: Whitworth
authors.forename: Kenneth
authors.initials: K
authors.lastname: Deck
authors.forename: Anne
authors.initials: A
authors.lastname: Rosenberg
authors.forename: Douglas
authors.initials: D
authors.lastname: Reintgen
authors.forename: Peter
authors.initials: P
authors.lastname: Beitsch
authors.forename: Anees
authors.initials: A
authors.lastname: Chagpar
authors.forename: Thomas
authors.initials: T
authors.lastname: Julian
authors.forename: Sukamal
authors.initials: S
authors.lastname: Saha
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Mamounas
authors.forename: Armando
authors.initials: A
authors.lastname: Giuliano
authors.forename: Rache
authors.initials: R
authors.lastname: Simmons
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D003951:Diagnostic Errors; D006801:Humans; D007430:Intraoperative Care; D009367:Neoplasm Staging; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy; D013048:Specimen Handling / Q000592:standards*