[Intraoperative determination of axillary node metastasis by RT-PCR].

Abstract

UNLABELLED:

The intraoperative determination of axillary node micrometastasis according to the Rapid GeneSearch Breast Lymph Node (BLN) is based on RT-PCR (mRNA of mammaglobine and CK19) detects metastases > 0.2 mm.

PATIENTS AND METHODS:

Eighty-three pts between November 2007 and June 2008 were included (33 from Centre Jean-Perrin and 50 from Centre Oscar-Lambret). Lymph nodes were cut in 2 mm slices, and 1 out of 2 was examined with BLN; the others were examined by imprints then histological exam with immunohistochemistry.

RESULTS:

Forteen pts had micro- or macrometastasis. Seven were positive with intraoperative imprints including six macrometastasis and one micrometastasis; seven were positive with BLN and seven at histological exam with two cases of discordance. Sensitivity was 92%, specificity 98%. Positive predictive value 92%, and negative predictive value 98%. The median time for intraoperative determination was 40 minutes for 2 SLN.

DISCUSSION:

Half each lymph node is study by each method. This explains the discordances observed. Limit of BLN is the absence of CTI detection; however there is no consensus about the necessity of axillary clearance in such a case.

CONCLUSION:

In this series BLN reduces axillary clearance and improves comfort patients.

• Authors: M-C Baranzelli, F Penault-Llorca, F Revillon, G Portefaix, F Mishellany, M-P Chauvet, S Giard, M-M Dauplat, P Gimbergues, Y-M Robin, J Dauplat, J Bonneterre
• Journal: Bulletin du cancer (Bull Cancer) Vol. 97 Issue 3 Pg. 349-55 (Mar 2010) ISSN: 1769-6917 [Electronic] France
• Vernacular Title: Utilisation d'une méthode PCR en temps réel pour l'étude des ganglions sentinelles dans les carcinomes mammaires : expérience des centres anticancéreux de Lille et de Clermont-Ferrand.
• PMID: 20123648 (Publication Type: English Abstract, Journal Article)

Topics

• Adult
• Axilla
• Breast Neoplasms (pathology, surgery)
• Female
• Humans
• Immunohistochemistry (methods)
• Intraoperative Period
• Lymphatic Metastasis (diagnosis)
• Reverse Transcriptase Polymerase Chain Reaction (methods)
• Sensitivity and Specificity
• Sentinel Lymph Node Biopsy (methods)