Sentinel Nodal Micrometastases Detected by the One- Step Nucleic Acid Amplification Whole Node Assay and the Impact on Adjuvant Treatment and Outcomes in Early Breast Cancers: The First Report from Thailand

2021 ◽  
Vol 104 (5) ◽  
pp. 764-771
Keyword(s):  
Adjuvant Treatment ◽  
Survival Benefit ◽  
Systemic Chemotherapy ◽  
Lymph Node Biopsy ◽  
Nucleic Acid Amplification ◽  
Node Biopsy ◽  
One Step ◽  
The One ◽  
The Impact ◽  
Osna Assay

Background: The advent of sentinel lymph node biopsy (SLNB) and improvements in histopathological and molecular analysis have increased the detection rate of nodal micrometastases. As compare with conventional method, the one-step nucleic acid amplification (OSNA) assay might detect higher cases of SLN micrometastases. Objective: The present study aimed to assess the impact of OSNA assay on micrometastases detection rate and potential benefit in terms of adjuvant treatment and survival outcome in early breast cancer. Materials and Methods: A retrospective review of patients with sentinel node (SLN) micrometastasis detected by the OSNA assay between 2015 and 2019 was carried out. Clinicopathological, adjuvant treatment, and follow-up data were collected. Ten-year survival benefit with adjuvant chemotherapy was calculated using PREDICT online, version 1.2 (https://breast.predict.nhs.uk/). Results: Between November 2015 and December 2019, 78 out of 721 patients (10.8%) were positive for micrometastasis based on OSNA detection. Three-fourth of cases received adjuvant systemic chemotherapy and 57% were given taxane-based regimen. Using the PREDICT online tool, an estimated 10-year survival in patients who received adjuvant systemic chemotherapy and who did not, were 75% and 66%, respectively (p=0.018). A 10-year survival benefit from chemotherapy among patients who received systemic chemotherapy was 8% compared with 4% with no-adjuvant-therapy cohort. Conclusion: The OSNA assay allows for a more precise detection of SLN micrometastasis compared to conventional pathology and could guide therapeutic decision making. In patients with micrometastasis who received adjuvant systemic chemotherapy, the estimated overall 10-year survival was improved. Keywords: Axillary staging, Breast cancer, Micrometastases, OSNA, Sentinel lymph node biopsy

scholarly journals Association of One-Step Nucleic Acid Amplification Detected Micrometastases with Tumour Biology and Adjuvant Chemotherapy

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Ghaleb Goussous ◽  
Sadaf Jafferbhoy ◽  
Niamh Smyth ◽  
Lisette Hammond ◽  
Sankaran Narayanan ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Adjuvant Chemotherapy ◽  
Sentinel Node ◽  
Survival Benefit ◽  
Nucleic Acid Amplification ◽  
Detection Rates ◽  
Tumour Biology ◽  
Number Of Patients ◽  
One Step ◽  
The Impact

One-step nucleic acid amplification (OSNA) is an intraoperative technique with a high sensitivity and specificity for sentinel node assessment. The aim of this study was to assess the impact of OSNA on micrometastases detection rates and use of adjuvant chemotherapy. A retrospective review of patients with sentinel node micrometastases over a five-year period was carried out and a comparison of micrometastases detection using OSNA and H&E techniques was made. Out of 1285 patients who underwent sentinel node (SLN) biopsy, 76 patients had micrometastases. Using H&E staining, 36 patients were detected with SLN micrometastases (9/year) in contrast to 40 patients in the OSNA year (40/year) (p<0.0001), demonstrating a fourfold increase with the use of OSNA. In the OSNA group, there was also a proportional increase in Grade III, triple-negative, ER-negative, and HER-2-positive tumours being diagnosed with micrometastases. Also on interactive PREDICT tool, the number of patients with a predicted 10-year survival benefit of more than 3% with adjuvant chemotherapy increased from 52 to 70 percent. OSNA has resulted in an increased detection rate of micrometastases especially in patients with aggressive tumour biology. This increased the number of patients who had a predicted survival benefit from adjuvant chemotherapy.

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