One Step Nucleic Acid Amplification Sentinel Lymph Node sampling as a predictor of axillary node status in early invasive breast cancer: a UK single centre experience
Association of Breast Surgery ePoster Library. Jerome E. 05/13/19; 257046; P002
Ms. Ellen Jerome
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P002
Topic: Axilla
Introduction:RD-100iOne-Step Nucleic Acid amplification (OSNA)system analyses and amplifies mRNA from solubilised sentinel lymph node sampling (SLN) by detecting the level of expression of the cytokeratin‑19 gene (CK19), an epithelial marker associated with breast cancer, giving a total tumour load (TTL) defined as the number of mRNA copies of CK19(copies/µmol/L) . TTL indicates the presence of micro or macrometastases, allowing the surgeon to intraoperatively proceed to axillary node clearance (ANC) where positive. Evidence has shown OSNA copy number to be a predictor of axillary node status and survival. Methods :A retrospective single centre cohort study of 728 patients undergoing wide local excision or mastectomy for early invasive breast cancer with intraoperative OSNA SLN or SLN preceding neoadjuvant chemotherapy was performed. Data was collected on tumour type, grade, size, presence of lymphovascular invasion, number of lymph nodes sampled, TTL, and histological metastases where ANC performed. TTL ≥5000 was taken as macrometastasis, and 250< TTL <5000 was taken as micrometastasis, TTL≥250000 was stratified as high risk. Results: :723 patients were underwent SLN sampling using OSNA. 17.2% (n=124) had macrometastases, 7.5% (n=54) had micrometastases. All patients with macrometastases underwent ANC and 61/124 had further histological lymph node metastases. Univariate logistic regression showed that (log)TTL was positively assocated with further axillary lymph node metastases (p=0.607). High risk TTL carried OR=1.38 for further axillary metastases.ConclusionTTL using OSNA is a predictor of axillary node status in our patient population with early invasive breast cancer, supporting current evidence.
Topic: Axilla
Introduction:RD-100iOne-Step Nucleic Acid amplification (OSNA)system analyses and amplifies mRNA from solubilised sentinel lymph node sampling (SLN) by detecting the level of expression of the cytokeratin‑19 gene (CK19), an epithelial marker associated with breast cancer, giving a total tumour load (TTL) defined as the number of mRNA copies of CK19(copies/µmol/L) . TTL indicates the presence of micro or macrometastases, allowing the surgeon to intraoperatively proceed to axillary node clearance (ANC) where positive. Evidence has shown OSNA copy number to be a predictor of axillary node status and survival. Methods :A retrospective single centre cohort study of 728 patients undergoing wide local excision or mastectomy for early invasive breast cancer with intraoperative OSNA SLN or SLN preceding neoadjuvant chemotherapy was performed. Data was collected on tumour type, grade, size, presence of lymphovascular invasion, number of lymph nodes sampled, TTL, and histological metastases where ANC performed. TTL ≥5000 was taken as macrometastasis, and 250< TTL <5000 was taken as micrometastasis, TTL≥250000 was stratified as high risk. Results: :723 patients were underwent SLN sampling using OSNA. 17.2% (n=124) had macrometastases, 7.5% (n=54) had micrometastases. All patients with macrometastases underwent ANC and 61/124 had further histological lymph node metastases. Univariate logistic regression showed that (log)TTL was positively assocated with further axillary lymph node metastases (p=0.607). High risk TTL carried OR=1.38 for further axillary metastases.ConclusionTTL using OSNA is a predictor of axillary node status in our patient population with early invasive breast cancer, supporting current evidence.
P002
Topic: Axilla
Introduction:RD-100iOne-Step Nucleic Acid amplification (OSNA)system analyses and amplifies mRNA from solubilised sentinel lymph node sampling (SLN) by detecting the level of expression of the cytokeratin‑19 gene (CK19), an epithelial marker associated with breast cancer, giving a total tumour load (TTL) defined as the number of mRNA copies of CK19(copies/µmol/L) . TTL indicates the presence of micro or macrometastases, allowing the surgeon to intraoperatively proceed to axillary node clearance (ANC) where positive. Evidence has shown OSNA copy number to be a predictor of axillary node status and survival. Methods :A retrospective single centre cohort study of 728 patients undergoing wide local excision or mastectomy for early invasive breast cancer with intraoperative OSNA SLN or SLN preceding neoadjuvant chemotherapy was performed. Data was collected on tumour type, grade, size, presence of lymphovascular invasion, number of lymph nodes sampled, TTL, and histological metastases where ANC performed. TTL ≥5000 was taken as macrometastasis, and 250< TTL <5000 was taken as micrometastasis, TTL≥250000 was stratified as high risk. Results: :723 patients were underwent SLN sampling using OSNA. 17.2% (n=124) had macrometastases, 7.5% (n=54) had micrometastases. All patients with macrometastases underwent ANC and 61/124 had further histological lymph node metastases. Univariate logistic regression showed that (log)TTL was positively assocated with further axillary lymph node metastases (p=0.607). High risk TTL carried OR=1.38 for further axillary metastases.ConclusionTTL using OSNA is a predictor of axillary node status in our patient population with early invasive breast cancer, supporting current evidence.
Topic: Axilla
Introduction:RD-100iOne-Step Nucleic Acid amplification (OSNA)system analyses and amplifies mRNA from solubilised sentinel lymph node sampling (SLN) by detecting the level of expression of the cytokeratin‑19 gene (CK19), an epithelial marker associated with breast cancer, giving a total tumour load (TTL) defined as the number of mRNA copies of CK19(copies/µmol/L) . TTL indicates the presence of micro or macrometastases, allowing the surgeon to intraoperatively proceed to axillary node clearance (ANC) where positive. Evidence has shown OSNA copy number to be a predictor of axillary node status and survival. Methods :A retrospective single centre cohort study of 728 patients undergoing wide local excision or mastectomy for early invasive breast cancer with intraoperative OSNA SLN or SLN preceding neoadjuvant chemotherapy was performed. Data was collected on tumour type, grade, size, presence of lymphovascular invasion, number of lymph nodes sampled, TTL, and histological metastases where ANC performed. TTL ≥5000 was taken as macrometastasis, and 250< TTL <5000 was taken as micrometastasis, TTL≥250000 was stratified as high risk. Results: :723 patients were underwent SLN sampling using OSNA. 17.2% (n=124) had macrometastases, 7.5% (n=54) had micrometastases. All patients with macrometastases underwent ANC and 61/124 had further histological lymph node metastases. Univariate logistic regression showed that (log)TTL was positively assocated with further axillary lymph node metastases (p=0.607). High risk TTL carried OR=1.38 for further axillary metastases.ConclusionTTL using OSNA is a predictor of axillary node status in our patient population with early invasive breast cancer, supporting current evidence.
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