1. An improved axillary staging system using the OSNA assay does not modify the therapeutic management of breast cancer patients
- Author
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Javier A. Menendez, Francesc Tuca-Rodríguez, Eugeni López-Bonet, Maria Buxó, Ester Vila-Camps, Elena Alvarez, Begoña Martin-Castillo, and Miguel Alonso Ruano
- Subjects
Adult ,medicine.medical_specialty ,Pathology ,Sentinel lymph node ,Breast Neoplasms ,Gastroenterology ,Article ,Breast cancer ,Internal medicine ,Biopsy ,medicine ,Carcinoma ,Humans ,Macrometastasis ,Aged ,Neoplasm Staging ,Multidisciplinary ,medicine.diagnostic_test ,business.industry ,Carcinoma, Ductal, Breast ,Micrometastasis ,Nucleic acid amplification technique ,Middle Aged ,medicine.disease ,Quality Improvement ,Axilla ,medicine.anatomical_structure ,Molecular Diagnostic Techniques ,Chemotherapy, Adjuvant ,Lymphatic Metastasis ,Female ,Lymph Nodes ,business ,Nucleic Acid Amplification Techniques - Abstract
The one-step nucleic acid amplification (OSNA) assay is a molecular procedure that can identify deposits of breast cancer (BC) cells in the sentinel lymph node (SLN). We examined the consistency of the OSNA assay with a classic hematoxylin-eosin (H&E)-based immunohistochemistry (IHC) study and evaluated how OSNA-based axillary staging might impact the therapeutic management of BC patients. SLN biopsy results were considered to be positive in 60 patients (40%) in the OSNA group (N = 148) and in 43 (28%) patients in the IHC cohort (N = 153, p = 0.023). There was no difference in the macrometastasis (22% for OSNA, 15% for H&E, p = 0.139) or micrometastasis (19% for OSNA, 13% for H&E, p = 0.166) rates, but we found statistically significant differences in the number of isolated tumor cells (1% for OSNA, 11% for H&E, p < 0.001). There were no differences in the administration rate of adjuvant systemic therapy between the OSNA (66% in the SLN+ patients) and the H&E (74% in the SLN+ patients) groups (p = 0.159). The OSNA assay allows for the detection of SLN metastases more precisely than conventional pathologic methods but does not alter the therapeutic management of SLN+ BC patients.
- Published
- 2014