Efficacy of immediate axillary clearance (AC) in Metasin positive sentinel lymph node (SLN) biopsy assay: A large single centre experience
Association of Breast Surgery ePoster Library. Marikakis N. 05/13/19; 257047; P003
Mr. Nikolaos Marikakis
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P003
Topic: Axilla
Introduction: Intra-operative assessment of the SLN allows an immediate AC to be performed in Metasin positive macrometastases (macro) patients. Surgical management of macro vs micrometastases (micro) is different. Differentiating between macro and micro is therefore essential and this can be done by intraoperative Polymerase Chain Reaction assay (qRT-PCR). The aim of this study is to assess the efficacy of immediate AC in Metasin positive patients. Methods : The metasin assay is an intraoperative molecular test which utilizes qRT-PCR to detect two predictive markers of metastases, Cytokeratin 19 (CK19) and Mammaglobin (MGB). Alternate 2 mm slices of SLNs were tested with metasin and the remainder by routine histological examination. Micro was defined as tumour deposit between 0.2mm and 2mm and macro over 2 mm on histology. Results: 230 of 1255 patients (18%) proceeded to immediate AC and were spared a second operation. 183 patients (80%) were macro and 47 (20%) micro on Metasin. 9 of 1255 patients (0.7%) underwent a delayed AC as histology of SLNs showed macro. Out of these, 4 were negative and 5 were micro on Metasin. 38 of 43 Metasin micro patients (88%) were spared an axillary clearance.Correlation of metasin vs histology - immediate ACsHistologyNegativePositivity in SLNs ONLYPositivity in at least ONE N-SLNsTotalMetasinMacrometastasis43 (23.5%)98 (53.5%)42 (23%)183Micrometastasis37 (78.7%)8 (17%, micro)2 (4.3%, micro)47Total8010644230Conclusions: Differentiating between macro and micro helps decide appropriate surgical management of the axilla. Fewer patients with Metasin macro should have AC. Patients with Metasin micro should not have AC.
Topic: Axilla
Introduction: Intra-operative assessment of the SLN allows an immediate AC to be performed in Metasin positive macrometastases (macro) patients. Surgical management of macro vs micrometastases (micro) is different. Differentiating between macro and micro is therefore essential and this can be done by intraoperative Polymerase Chain Reaction assay (qRT-PCR). The aim of this study is to assess the efficacy of immediate AC in Metasin positive patients. Methods : The metasin assay is an intraoperative molecular test which utilizes qRT-PCR to detect two predictive markers of metastases, Cytokeratin 19 (CK19) and Mammaglobin (MGB). Alternate 2 mm slices of SLNs were tested with metasin and the remainder by routine histological examination. Micro was defined as tumour deposit between 0.2mm and 2mm and macro over 2 mm on histology. Results: 230 of 1255 patients (18%) proceeded to immediate AC and were spared a second operation. 183 patients (80%) were macro and 47 (20%) micro on Metasin. 9 of 1255 patients (0.7%) underwent a delayed AC as histology of SLNs showed macro. Out of these, 4 were negative and 5 were micro on Metasin. 38 of 43 Metasin micro patients (88%) were spared an axillary clearance.Correlation of metasin vs histology - immediate ACsHistologyNegativePositivity in SLNs ONLYPositivity in at least ONE N-SLNsTotalMetasinMacrometastasis43 (23.5%)98 (53.5%)42 (23%)183Micrometastasis37 (78.7%)8 (17%, micro)2 (4.3%, micro)47Total8010644230Conclusions: Differentiating between macro and micro helps decide appropriate surgical management of the axilla. Fewer patients with Metasin macro should have AC. Patients with Metasin micro should not have AC.
P003
Topic: Axilla
Introduction: Intra-operative assessment of the SLN allows an immediate AC to be performed in Metasin positive macrometastases (macro) patients. Surgical management of macro vs micrometastases (micro) is different. Differentiating between macro and micro is therefore essential and this can be done by intraoperative Polymerase Chain Reaction assay (qRT-PCR). The aim of this study is to assess the efficacy of immediate AC in Metasin positive patients. Methods : The metasin assay is an intraoperative molecular test which utilizes qRT-PCR to detect two predictive markers of metastases, Cytokeratin 19 (CK19) and Mammaglobin (MGB). Alternate 2 mm slices of SLNs were tested with metasin and the remainder by routine histological examination. Micro was defined as tumour deposit between 0.2mm and 2mm and macro over 2 mm on histology. Results: 230 of 1255 patients (18%) proceeded to immediate AC and were spared a second operation. 183 patients (80%) were macro and 47 (20%) micro on Metasin. 9 of 1255 patients (0.7%) underwent a delayed AC as histology of SLNs showed macro. Out of these, 4 were negative and 5 were micro on Metasin. 38 of 43 Metasin micro patients (88%) were spared an axillary clearance.Correlation of metasin vs histology - immediate ACsHistologyNegativePositivity in SLNs ONLYPositivity in at least ONE N-SLNsTotalMetasinMacrometastasis43 (23.5%)98 (53.5%)42 (23%)183Micrometastasis37 (78.7%)8 (17%, micro)2 (4.3%, micro)47Total8010644230Conclusions: Differentiating between macro and micro helps decide appropriate surgical management of the axilla. Fewer patients with Metasin macro should have AC. Patients with Metasin micro should not have AC.
Topic: Axilla
Introduction: Intra-operative assessment of the SLN allows an immediate AC to be performed in Metasin positive macrometastases (macro) patients. Surgical management of macro vs micrometastases (micro) is different. Differentiating between macro and micro is therefore essential and this can be done by intraoperative Polymerase Chain Reaction assay (qRT-PCR). The aim of this study is to assess the efficacy of immediate AC in Metasin positive patients. Methods : The metasin assay is an intraoperative molecular test which utilizes qRT-PCR to detect two predictive markers of metastases, Cytokeratin 19 (CK19) and Mammaglobin (MGB). Alternate 2 mm slices of SLNs were tested with metasin and the remainder by routine histological examination. Micro was defined as tumour deposit between 0.2mm and 2mm and macro over 2 mm on histology. Results: 230 of 1255 patients (18%) proceeded to immediate AC and were spared a second operation. 183 patients (80%) were macro and 47 (20%) micro on Metasin. 9 of 1255 patients (0.7%) underwent a delayed AC as histology of SLNs showed macro. Out of these, 4 were negative and 5 were micro on Metasin. 38 of 43 Metasin micro patients (88%) were spared an axillary clearance.Correlation of metasin vs histology - immediate ACsHistologyNegativePositivity in SLNs ONLYPositivity in at least ONE N-SLNsTotalMetasinMacrometastasis43 (23.5%)98 (53.5%)42 (23%)183Micrometastasis37 (78.7%)8 (17%, micro)2 (4.3%, micro)47Total8010644230Conclusions: Differentiating between macro and micro helps decide appropriate surgical management of the axilla. Fewer patients with Metasin macro should have AC. Patients with Metasin micro should not have AC.
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