Intraoperative molecular analysis of sentinel lymph nodes following neoadjuvant chemotherapy in patients with clinical node negative breast cancer: An institutional study

Parada,David; Peña,Karla   B.; Riu,F.  Francesc; Aguilar,A.  Esther; Cohan,Sebastian

doi:10.3892/mco.2016.1025

Intraoperative molecular analysis of sentinel lymph nodes following neoadjuvant chemotherapy in patients with clinical node negative breast cancer: An institutional study

Authors:
- David Parada
- Karla B. Peña
- F. Francesc Riu
- A. Esther Aguilar
- Sebastian Cohan
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Affiliations: Department of Pathology, University Hospital Sant Joan de Reus, University Rovira i Virgill, E-43201 Tarragona, Spain, Department of Gynecology, University Hospital Sant Joan de Reus, E-43204 Tarragona, Spain, Department of Radiodiagnostics, University Hospital Sant Joan de Reus, E-43204 Tarragona, Spain
Published online on: September 21, 2016 https://doi.org/10.3892/mco.2016.1025
Pages: 507-510
Copyright: © Parada et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Sentinel lymph node biopsy (SLNB) is an accurate, safe method for determining the axillary lymph node status. However, insufficient evidence exists to support the recommendation of SLNB in patients who have had neoadjuvant chemotherapy (NAC) to downsize tumours and allow for breast conservation surgery. The present study aimed to use molecular approaches to evaluate the feasibility and accuracy of SLNB in patients treated with NAC prior to SLN mapping and surgery. A total of 50 consecutive patients with operable invasive breast carcinomas who had received prior NAC were assessed using the one-step nucleic acid amplification (OSNA) method. The rate of SLN identification was 100%. The OSNA assay showed that 29 patients (58%) were negative for SLN and 21 patients (42%) were positive. In 19 of these 21 patients (90.48%), the SLN was the only positive lymph node. No axillary lymph nodes metastases were observed in patients with isolated tumour cells or with micrometastases. The OSNA assay is a highly sensitive, specific and reproducible diagnostic technique that can be used to analyse SLNs following NAC. The total tumoral load may assist with predicting additional non-SLN metastases.

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