One-step Nucleic Acid Amplification Can Identify Sentinel Node-negative Breast Cancer Patients With Excellent Prognosis

Background/aim One-step nucleic acid amplification (OSNA) is a newly developed procedure for detection of node metastasis by targeting CK19 mRNA. This study aimed to compare the prognosis of ER-positive/HER2-negative (ER+/HER2-) breast cancer patients with negative sentinel lymph node (SLN), as determined by OSNA with that determined by pathology. Patients and methods A total of 508 patients who underwent breast surgery and SLN biopsy were enrolled. Of 263 patients with negative SLN by OSNA (osN0), 239 were treated with endocrine therapy alone (osN0-ET), and of 107 with negative SLN by pathology (pN0), 103 were treated with endocrine therapy alone (pN0-ET). Results Distant relapse-free survival (DRFS) of osN0-ET group (99.5% at 6 years) was significantly better (p=0.044) than that of pN0-ET group. Multivariate analysis revealed that osN0 was significantly associated (p=0.019) with favorable DRFS. Conclusion ER+/HER2- breast cancer patients with negative SLN by OSNA show an excellent prognosis with endocrine therapy alone.