title: Sentinel lymph node analysis in breast cancer: contribution of one-step nucleic acid amplification (OSNA).
abstract: One-step nucleic acid amplification (OSNA, Sysmex, Kobe, Japan) offers an excellent opportunity for accurate exhaustive sentinel lymph node (SLN) examination in breast cancer patients. Calibrated with conventional postoperative histology, this molecular technique yields comparable results intraoperatively, expressed as micrometastasis, macrometastasis or no metastasis depending on the CK19 mRNA copy number amplified in SLN lysates. We applied OSNA to detect metastasis in 810 SLNs from 367 patients with early stage breast cancer. We compared the rate of OSNA-positive SLNs in patients with invasive breast cancer (< 2 cm) versus the rate observed in a historical cohort using conventional histological examination of SLNs. No significant difference was observed, the OSNA assay was positive in 24.4% of patients, compared with positive histology in 24.8% in the historical cohort if including patients with isolated tumour cell (ITC) and in 23.4% excluding them. Opportunities for optimised patient management using OSNA are discussed: intraoperative detection of OSNA-positive SLNs enables axillary lymph node dissection (ALND) during the same procedure; standard OSNA techniques enable the establishment of homogeneous groups based on examination of whole SLNs for valid comparisons between different centres.
authors: Regional Mastology Center, Departement of Biology, Eugène Marquis Comprehensive Cancer Center, CS 44 229, Avenue de Bataille Flandres Dunkerques, 35 042 Rennes Cedex, France. f.godey@rennes.unicancer.fr
authors: Florence
authors: F
authors: Godey
authors: Jean
authors: J
authors: Leveque
authors: Patrick
authors: P
authors: Tas
authors: Gwenola
authors: G
authors: Gandon
authors: Philippe
authors: P
authors: Poree
authors: Habiba
authors: H
authors: Mesbah
authors: Vincent
authors: V
authors: Lavoue
authors: Véronique
authors: V
authors: Quillien
authors: Cécile Bendavid
authors: CB
authors: Athias
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D021141:Nucleic Acid Amplification Techniques; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy