A New Possible Cut-Off of Cytokeratin 19 mRNA Copy Number by OSNA in the Sentinel Node of Breast Cancer Patients to Avoid Unnecessary Axillary Dissection: A 10-Year Experience in a Tertiary Breast Unit
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Intraoperative SLN Analysis with OSNA Assay
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | No ALN+ (n = 86) | ≥1 ALN+ (n = 116) | p-Value |
---|---|---|---|
Age | 51 (49–55) | 48 (47–53) | 0.41 |
BMI (Kg/m2) | 25 (22–27) | 26 (24–28) | 0.33 |
Surgical treatment | |||
Conservative | 72 (84%) | 95 (82%) | 0.8 |
Mastectomy | 14 (16%) | 21 (18%) | 0.8 |
Histological type | |||
Invasive Ductal carcinoma | 71 (82.5%) | 88 (75.8%) | 0.32 |
Invasive Lobular carcinoma | 9 (10.5%) | 19 (16.4%) | 0.31 |
Invasive Ductal and Lobular carcinoma | 3 (3.5%) | 6 (5.2%) | 0.7 |
Ductal Carcinoma In Situ | 0 | 2 (1.7%) | 0.5 |
Other | 3 (3.5%) | 1 (0.9%) | 0.3 |
Tumor size | |||
pT1a | 2 (2.3%) | 1 (0.9%) | 0.5 |
pT1b | 20 (23.3%) | 12 (10.2%) | * <0.05 |
pT1c | 40 (46.5%) | 37 (32%) | * <0.05 |
pT2 | 23 (26.7%) | 52 (44.8%) | * <0.05 |
pT3 | 1 (1.2%) | 14 (12.1%) | * <0.005 |
Grading | |||
1 | 12 (14%) | 5 (4%) | * <0.05 |
2 | 45 (52%) | 46 (40%) | 0.09 |
3 | 29 (34%) | 65 (56%) | * <0.005 |
Estrogen Receptor status | |||
Positive | 74 (86%) | 95 (82%) | 0.5 |
Negative | 12 (14%) | 21 (18%) | 0.5 |
Progesterone Receptor status | |||
Positive | 47 (54.6%) | 61 (52.5%) | 0.8 |
Negative | 39 (45.4%) | 55 (47.5%) | 0.8 |
HER2 expression by IHC | |||
Positive | 28 (32.5%) | 37 (32%) | 1 |
Negative | 58 (67.5%) | 79 (68%) | 1 |
Ki67% | |||
<20% | 47 (54.6%) | 68 (58.6%) | 0.6 |
≥20% | 39 (45.4%) | 48 (41.4%) | 0.6 |
Surrogate molecular subtypes | |||
Luminal A | 30 (35%) | 46 (40%) | 0.5 |
Luminal B | 47(54.6%) | 56 (48%) | 0.4 |
HER2 enriched | 5 (5.8%) | 7 (6%) | 1 |
Triple-negative | 4 (4.6%) | 7 (6%) | 0.7 |
Characteristics | No ALN+ (n = 86) | ≥1 ALN+ (n = 116) | p-Value |
---|---|---|---|
SLN size (main) | 1.5 cm (1.2–2) | 1.5 cm (1.2–1.9) | 0.9 |
SLN weight | 0.58 gm (0.4–0.9) | 0.6 gm (0.4–0.9) | 0.2 |
SLN CK19 mRNA copies | 49,500 (range 11,625–179,700) | 89,000 (range 20,000–443,350) | * <0.05 |
LNs removed at ALND | 19 (17–24) | 21 (17.75–24.25) | 0.3 |
LNs positive at ALND | 0 | 3 (2–5) | * <0.005 |
Study | N. of Pts | Cut-Off (Copies/µL) | Years | AUC (%) | Se (%) | Sp (%) | PPV (%) | NPV (%) | Method |
---|---|---|---|---|---|---|---|---|---|
Present study | 1339 202 ++ 126 + | 9150 | 13 | 82.1 | 94 | 67.3 | 61.2 | 95.3 | Maximalcopy |
Tsujimoto et al. [6] | 5000 | 78.6 | 56.8 | 44.8 | 85.6 | Maximal copy | |||
Deambrogio et al. [29] | 1296 117 ++ 123 + | 7700 | 3 | 69 | 78 | 57 | 50 | 83 | |
Pina et al. [30] | 812 197 ++ | 5000 | 4 | 77 | 75 | 72 | 40.5 | 91.9 | Maximal copy |
Heilmann et al. [31] | 143 39 ++ | 7900 | 91 | 61 | 1 mm central for histology, rest for OSNA | ||||
Peg et al.* [32] | 697 ++ | 15,000 | 1 | 70 | 76.7 | 55.2 | 41.1 | 85.5 | TTL |
Terrenato et al. | 1140 172 ++ 146 + | 2150 | 3 | 76 | 94.9 | 51.4 | 46.5 | 95.8 | TTL |
Nabais et al. [33] | 598 58 ++ | 190,000 | 4 | 80 | 73.3 | 74.4 | 88.9 | TTL | |
Espinosa-Bravo et al. * [34] | 306 108 ++ | 120,000 | 1 | 71 | 47 | 85.3 | 56 | 80 | TTL |
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Tomasicchio, G.; Mastropasqua, M.G.; Picciariello, A.; Montanaro, A.E.; Signorile, D.; Cirilli, A.; Punzo, C. A New Possible Cut-Off of Cytokeratin 19 mRNA Copy Number by OSNA in the Sentinel Node of Breast Cancer Patients to Avoid Unnecessary Axillary Dissection: A 10-Year Experience in a Tertiary Breast Unit. Cancers 2022, 14, 3384. https://doi.org/10.3390/cancers14143384
Tomasicchio G, Mastropasqua MG, Picciariello A, Montanaro AE, Signorile D, Cirilli A, Punzo C. A New Possible Cut-Off of Cytokeratin 19 mRNA Copy Number by OSNA in the Sentinel Node of Breast Cancer Patients to Avoid Unnecessary Axillary Dissection: A 10-Year Experience in a Tertiary Breast Unit. Cancers. 2022; 14(14):3384. https://doi.org/10.3390/cancers14143384
Chicago/Turabian StyleTomasicchio, Giovanni, Mauro Giuseppe Mastropasqua, Arcangelo Picciariello, Alda Elena Montanaro, Daniela Signorile, Alfredo Cirilli, and Clelia Punzo. 2022. "A New Possible Cut-Off of Cytokeratin 19 mRNA Copy Number by OSNA in the Sentinel Node of Breast Cancer Patients to Avoid Unnecessary Axillary Dissection: A 10-Year Experience in a Tertiary Breast Unit" Cancers 14, no. 14: 3384. https://doi.org/10.3390/cancers14143384