Promoter hypermethylation in sentinel lymph nodes as a marker for breast cancer recurrence.
OBJECTIVE
Promoter methylation of tumor suppressor genes in histologically negative sentinel lymph nodes (HNSN) of early stage breast cancer patients has not been extensively studied. This study evaluates the methylation frequency and pattern in HNSN to determine if detection of hypermethylation of one or more genes is associated with an increased recurrence risk in node negative breast cancer.


METHODS
In 1998, a prospective study of patients with early stage breast cancer and HNSN was initiated in order to correlate sentinel node analysis with clinical outcome. Nodal tissue was selected from 120 HNSN patients for methylation analysis in at least one and up to six sentinel nodes using a panel of nine genes. Corresponding primary breast tumors from 79 patients were also evaluated for hypermethylation. Methylation analysis was performed using nested Methylation Sensitive PCR (n-MSP). Logistical regression was used to evaluate the relationship between clinical recurrence and methylation status.


RESULTS
Over a median follow-up of 79 months, 13 of the 120 patients had clinical recurrence. Hypermethylation of genes was frequently observed in HNSN, but there was no correlation of methylation pattern and clinical recurrence. However, increased frequency of gene methylation of the primary tumor correlated with clinical recurrence.


CONCLUSIONS
Although hypermethylation of multiple genes occurs frequently in HNSN of breast cancer patients, it is not associated with breast cancer recurrence in the first 7 years of clinical follow-up.
Carraway
Hetty E
HE
Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, Baltimore, MD 21231, USA. Hcarraw1@jhmi.edu
Wang
Shelun
S
Blackford
Amanda
A
Guo
Mingzho
M
Powers
Penny
P
Jeter
Stacie
S
Davidson
Nancy E
NE
Argani
Pedram
P
Terrell
Kyle
K
Herman
James G
JG
Lange
Julie R
JR
D014408:Biomarkers, Tumor / Q000235:genetics*; D001943:Breast Neoplasms / Q000235:genetics* / Q000473:pathology / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000235:genetics / Q000556:secondary / Q000628:therapy; D018275:Carcinoma, Lobular / Q000235:genetics / Q000556:secondary / Q000628:therapy; D019175:DNA Methylation; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000235:genetics* / Q000473:pathology / Q000628:therapy; D016133:Polymerase Chain Reaction; D011379:Prognosis; D011401:Promoter Regions, Genetic / Q000235:genetics*; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy; D015996:Survival Rate; D025521:Tumor Suppressor Proteins / Q000235:genetics
D014408:Biomarkers, Tumor; D025521:Tumor Suppressor Proteins