[Intraoperative determination of axillary node metastasis by RT-PCR].
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.
Baranzelli
M-C
MC
Centre Oscar-Lambret, 3, rue Frédérique-Combemale, 59020 Lille cedex, France, Centre Jean-Perrin, boulevard Trudaine, 63000 Clermont-Ferrand, France.
Penault-Llorca
F
F
Revillon
F
F
Portefaix
G
G
Mishellany
F
F
Chauvet
M-P
MP
Giard
S
S
Dauplat
M-M
MM
Gimbergues
P
P
Robin
Y-M
YM
Dauplat
J
J
Bonneterre
J
J
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*