title: [One-step nucleic acid amplification (OSNA) assay for sentinel lymph node metastases as an alternative to conventional postoperative histology in breast cancer: A cost-benefit analysis].
abstract: BACKGROUND
  Intraoperative molecular analysis for sentinel lymph node (SLN) metastases using the OSNA (one-step nucleic acid amplification) method has been already validated in breast cancer. The authors compared the cost of OSNA versus the conventional postoperative histopathologic evaluation in patients with breast cancer.
  
  
  METHODS
  Patients with operable breast cancer and clinically and sonographic negative evaluation of the axilla, and who subsequently were operated on between the 15th of October 2008 and the 15th of December 2009 were included in this retrospective cost-benefit analysis. The SLN was assessed by conventional postoperative histological evaluation in Group 1 (45 patients), and by OSNA in Group 2 (35 patients). The following variables were analysed: age, tumour size, histological type, number of SLNs, biopsy result, duration of surgery, days in hospital, postoperative complications, positive lymph nodes in the case of axillary lymphadectomy, cost per patient, hospitalisation cost, and cost per operation.
  
  
  RESULTS
  The duration of surgery of the first operation in Group 1 was significantly shorter, but the total time was also higher in this group. The mean hospital stay was longer in Group 1 (P<.001). The mean cost of the hospital stay was higher in Group 1 compared to Group 2 (P<.001), with a mean difference of 199.69 €. The mean cost of the surgery was higher in Group 1 (P<.001), with a mean difference of 157.49 €. The mean cost per SLN analysis was significantly higher in Group 1, with a mean difference of 162.5 €. The cost per patient was significantly higher in Group 1 (P<.005). A mean saving of 439.67 € per patient was achieved by using the OSNA method.
  
  
  CONCLUSIONS
  Intraoperative molecular analysis for SLN metastases using the OSNA method reduces the number of admission days, duration of surgery, and achieves a saving of 439.67 € per patient.
authors.affiliation: Servicio Cirugía General y Digestivo, Hospital Morales Meseguer, Murcia, España. magirapi@hotmail.com
authors.forename: María Pilar
authors.initials: MP
authors.lastname: Guillén-Paredes
authors.forename: Luis
authors.initials: L
authors.lastname: Carrasco-González
authors.forename: Asunción
authors.initials: A
authors.lastname: Cháves-Benito
authors.forename: Alvaro
authors.initials: A
authors.lastname: Campillo-Soto
authors.forename: Andrés
authors.initials: A
authors.lastname: Carrillo
authors.forename: José Luis
authors.initials: JL
authors.lastname: Aguayo-Albasini
mesh_terms: D001943:Breast Neoplasms / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008207:Lymphatic Metastasis / Q000235:genetics; D008875:Middle Aged; D021141:Nucleic Acid Amplification Techniques / Q000191:economics* / Q000379:methods*; D011182:Postoperative Care; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000191:economics* / Q000379:methods*