title: [Intraoperative determination of axillary node metastasis by RT-PCR].
abstract: The intraoperative determination of axillary node micrometastasis according to the Rapid GeneSearch Breast Lymph Node (BLN) is based on RT-PCR (mRNA of mammaglobine and CK19) detects metastases > 0.2 mm.
  
  
  METHODS
  Eighty-three pts between November 2007 and June 2008 were included (33 from Centre Jean-Perrin and 50 from Centre Oscar-Lambret). Lymph nodes were cut in 2 mm slices, and 1 out of 2 was examined with BLN; the others were examined by imprints then histological exam with immunohistochemistry.
  
  
  RESULTS
  Forteen pts had micro- or macrometastasis. Seven were positive with intraoperative imprints including six macrometastasis and one micrometastasis; seven were positive with BLN and seven at histological exam with two cases of discordance. Sensitivity was 92%, specificity 98%. Positive predictive value 92%, and negative predictive value 98%. The median time for intraoperative determination was 40 minutes for 2 SLN.
  
  
  CONCLUSIONS
  Half each lymph node is study by each method. This explains the discordances observed. Limit of BLN is the absence of CTI detection; however there is no consensus about the necessity of axillary clearance in such a case.
  
  
  CONCLUSIONS
  In this series BLN reduces axillary clearance and improves comfort patients.
authors.affiliation: Centre Oscar-Lambret, 3, rue Frédérique-Combemale, 59020 Lille cedex, France, Centre Jean-Perrin, boulevard Trudaine, 63000 Clermont-Ferrand, France.
authors.forename: M-C
authors.initials: MC
authors.lastname: Baranzelli
authors.forename: F
authors.initials: F
authors.lastname: Penault-Llorca
authors.forename: F
authors.initials: F
authors.lastname: Revillon
authors.forename: G
authors.initials: G
authors.lastname: Portefaix
authors.forename: F
authors.initials: F
authors.lastname: Mishellany
authors.forename: M-P
authors.initials: MP
authors.lastname: Chauvet
authors.forename: S
authors.initials: S
authors.lastname: Giard
authors.forename: M-M
authors.initials: MM
authors.lastname: Dauplat
authors.forename: P
authors.initials: P
authors.lastname: Gimbergues
authors.forename: Y-M
authors.initials: YM
authors.lastname: Robin
authors.forename: J
authors.initials: J
authors.lastname: Dauplat
authors.forename: J
authors.initials: J
authors.lastname: Bonneterre
mesh_terms: D000328:Adult; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007432:Intraoperative Period; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*