BACKGROUND: The purpose of this single-center study was to determine the practicability of the intra-operative use of one-step nucleic acid amplification (OSNA) as the only method for detection of SLN. The OSNA system has been well described and is supposed to be as accurate as conventional histology. METHODS: Three hundred and thirty SLNs from 143 breast cancer patients were analyzed in an intra-operative setting. The CK19-copy number was determined by OSNA and divided into 3 results ("-" no metastasis; "+" micrometastasis; "++" marcometastasis). If OSNA gave a positive result, an axillary lymph node dissection was carried out during the same session. The central 1-mm slice of each node was obtained for permanent histology. Additionally, the results were correlated to clinicopathological factors, and the time for the intra-operative use was evaluated. RESULTS: Thirty-nine of the 143 patients were OSNA positive, 22 with macrometastatic and 17 with micrometastatic spread. The mean time for the OSNA run with one SLN was 34.4 min. We could show a correlation between the tumor size and OSNA positivity as well as between the numbers of OSNA positive SLNs with the tumor load of associated non-SLNs. Furthermore, we found that a cutoff CK19 copy number of 7,900/μL indicates a positive non-SLN result with the highest sensitivity (91 %) and specificity (61 %). CONCLUSION: We found OSNA to be very helpful for the intra-operative determination of the tumor load of a SLN as a basis for decision-making concerning further surgical axillary intervention. OSNA allows precise differentiation of micro- from macrometastasis, and the CK19 copy number predicts the probability of tumor load in other axillary lymph nodes and might help to find adequate adjuvant treatment options. This objective method is well suitable for everyday use and may reduce the pathologic workload and the risk of secondary operative interventions with all associated costs and stress for the patients.
BACKGROUND: The purpose of this single-center study was to determine the practicability of the intra-operative use of one-step nucleic acid amplification (OSNA) as the only method for detection of SLN. The OSNA system has been well described and is supposed to be as accurate as conventional histology. METHODS: Three hundred and thirty SLNs from 143 breast cancerpatients were analyzed in an intra-operative setting. The CK19-copy number was determined by OSNA and divided into 3 results ("-" no metastasis; "+" micrometastasis; "++" marcometastasis). If OSNA gave a positive result, an axillary lymph node dissection was carried out during the same session. The central 1-mm slice of each node was obtained for permanent histology. Additionally, the results were correlated to clinicopathological factors, and the time for the intra-operative use was evaluated. RESULTS: Thirty-nine of the 143 patients were OSNA positive, 22 with macrometastatic and 17 with micrometastatic spread. The mean time for the OSNA run with one SLN was 34.4 min. We could show a correlation between the tumor size and OSNA positivity as well as between the numbers of OSNA positive SLNs with the tumor load of associated non-SLNs. Furthermore, we found that a cutoff CK19 copy number of 7,900/μL indicates a positive non-SLN result with the highest sensitivity (91 %) and specificity (61 %). CONCLUSION: We found OSNA to be very helpful for the intra-operative determination of the tumor load of a SLN as a basis for decision-making concerning further surgical axillary intervention. OSNA allows precise differentiation of micro- from macrometastasis, and the CK19 copy number predicts the probability of tumor load in other axillary lymph nodes and might help to find adequate adjuvant treatment options. This objective method is well suitable for everyday use and may reduce the pathologic workload and the risk of secondary operative interventions with all associated costs and stress for the patients.
Authors: K L Snook; G T Layer; P A Jackson; C S de Vries; S Shousha; H D Sinnett; E Nigar; H Singhal; Y Chia; G Cunnick; M W Kissin Journal: Br J Surg Date: 2010-12-23 Impact factor: 6.939
Authors: Marie-Aude Le Frère-Belda; Anne-Sophie Bats; Florence Gillaizeau; Bruno Poulet; Krishna B Clough; Claude Nos; Michel Peoc'h; Pierre Seffert; Catherine Bouteille; Agnès Leroux; François Guillemin; Cécile Blanc-Fournier; Hubert Crouet; Laurent Arnould; Jean Cuisenier; Frédérique Penault-Llorca; Pierre Gimbergues; Jocelyne Jacquemier; Gilles Houvenaeghel; Gilles Chatellier; Fabrice Lécuru Journal: Int J Cancer Date: 2011-08-27 Impact factor: 7.396
Authors: P Gimbergues; M M Dauplat; A Cayre; X Durando; G Le Bouedec; F Finat-Duclos; G Portefaix; F Kwiatkowski; J Dauplat; F Penault-Llorca; A Tchirkov Journal: Eur J Surg Oncol Date: 2006-10-27 Impact factor: 4.424
Authors: M Espinosa-Bravo; I Sansano; S Pérez-Hoyos; M Ramos; M Sancho; J Xercavins; I T Rubio; V Peg Journal: Eur J Surg Oncol Date: 2013-04-19 Impact factor: 4.424
Authors: John A Olson; Linda M McCall; Peter Beitsch; Pat W Whitworth; Douglas S Reintgen; Peter W Blumencranz; A Marilyn Leitch; Sukamal Saha; Kelly K Hunt; Armando E Giuliano Journal: J Clin Oncol Date: 2008-07-20 Impact factor: 44.544
Authors: Mike Visser; Mehdi Jiwa; Anja Horstman; Antoinette A T P Brink; Rene P Pol; Paul van Diest; Peter J F Snijders; Chris J L M Meijer Journal: Int J Cancer Date: 2008-06-01 Impact factor: 7.396
Authors: Y Ohi; Y Umekita; Y Sagara; Y Rai; D Yotsumoto; A Matsukata; S Baba; S Tamada; Y Matsuyama; M Ando; Y Sagara; M Sasaki; S Tsuchimochi; A Tanimoto; Y Sagara Journal: Br J Cancer Date: 2012-08-28 Impact factor: 7.640