P011 A new clinical cut-off of cytokeratin 19 mRNA copy number in sentinel lymph node of breast cancer

The Breast ◽  
2015 ◽  
Vol 24 ◽  
pp. S29
Author(s):  
S. Buglioni ◽  
I. Terrenato ◽  
B. Casini ◽  
V. D'Alicandro ◽  
F. Di Filippo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Copy Number ◽  
Cytokeratin 19 ◽  
Mrna Copy Number

Real-Time Reverse-Transcription PCR to Quantify a Panel of 19 Genes in Breast Cancer: Relationships with Sentinel Lymph Node Invasion

2008 ◽  
Vol 23 (1) ◽  
pp. 10-17 ◽  
Author(s):  
F. Révillion ◽  
V. Lhotellier ◽  
L. Hornez ◽  
A. Leroy ◽  
M.C. Baranzelli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Growth Factor ◽  
Sentinel Lymph Node ◽  
Real Time ◽  
Critical Role ◽  
Cytokeratin 19 ◽  
Axillary Lymph ◽  
Mucin 1 ◽  
Her3 Expression

At the Centre Oscar Lambret, the anticancer centre of the North of France, sentinel lymph node (SLN) procedures are routinely performed for localized (T0–T1, N0, M0) breast carcinoma without any previous treatment, in order to prevent the deleterious effects of axillary lymph node dissection. The present study was undertaken to assess if the expression in the tumor of a panel of 19 genes would allow to predict histological SLN involvement. We looked at cytokeratin 19 (CK19), mucin-1 (MUC1), mammaglobin (MGB1), cyclin D1 (CCND1), the four members of the HER/ErbB growth factor receptor family (EGFR, HER2–4), insulin-like growth factor-1 receptor (IGF-1R), estradiol receptors (ERcx, ERβ), progesterone receptor (PR), vascular endothelial growth factors (VEGF, VEGF-C), urokinase-like plasminogen activator (uPA), matrix metalloproteinases 2 and 9 (MMP2, MMP9), ets-related transcription factor ERM, and E-cadherin (CDH1). Their expression was quantified by real-time RT-PCR in 134 breast cancer samples and the relationships with SLN metastases were analyzed. A slight increase (35–40%) in CK19 and HER3 expression was observed in the tumors of patients with SLN metastases compared to those of patients without metastases, even if neither CK19 expression nor HER3 expression allowed to distinguish patients with micrometastases from patients with macrometastases. We conclude that the tumoral expression of biological parameters involved in cell proliferation or playing a critical role in the metastatic process, including tumor invasion and angiogenesis, is not strongly associated with SLN metastases.

The use of one-step nucleic acid amplification (OSNA) and tumor-related factors in the axillary management of breast cancer: A predictive model.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 61-61
Author(s):  
Shramana Mitul Banerjee ◽  
Norman R. Williams ◽  
Timothy Ian Davidson ◽  
Soha El-Sheikh ◽  
My-annh Tran-Dang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Nucleic Acid ◽  
Sentinel Lymph Node ◽  
Copy Number ◽  
Nucleic Acid Amplification ◽  
Nodal Involvement ◽  
Related Factors ◽  
One Step ◽  
Node Metastases

61 Background: Recent trends in surgical practice advocate selective use of axillary nodal clearance (ANC) following sentinel lymph node biopsy (SNB) in the treatment of breast cancer. We aimed to determine the effectiveness of one-step nucleic acid amplification (OSNA) using CK19 mRNA copy number and tumor-related factors in predicting non-sentinel axillary nodal involvement, in order to formulate local guidelines for ANC. Methods: Patients due to have SNB at our institution for invasive breast cancer as well as selected patients with high grade ductal carcinoma in situ with negative assessment of the axilla on pre-operative imaging were included. Alternate slices of each node were sent for assessment by either OSNA or Histopathology. Immediate ANC was performed if OSNA was positive. The CK19 mRNA copy number, the total tumor load (summation of m RNA copy number of positive nodes,TTL), the total nodal status at ANC and tumor characteristics including grade, tumor size and lymphovascular invasion (LVI) for each patient were determined. A model of risk probability was constructed using TTL and tumor related factors. Results: 664 nodes were examined from 425 patients who had SNB performed between 2011 and 2014. After excluding 8 patients who did not meet the study criteria, 648 nodes from 417 patients were included for analysis. The concordance between OSNA and histology was 91.4%; positive predictive value (PPV) and negative predictive value (NPV) was 77% and 97% respectively. Patients with TTL less than 1400 did not have additional non sentinel lymph node involvement. TTL (p<0.01), and presence of LVI (p<0.05) were predictive for additional nodal involvement. The risk model identified all patients with more than 2 positive nodes as requiring ANC. All patients with non-sentinel node metastases at ANC were selected. Conclusions: OSNA is a sensitive and reliable intraoperative method for the detection of sentinel node metastases. Our study has shown it can also be used to predict the presence of non-sentinel metastases. Patients deemed high risk may be offered immediate ANC while axillary surgery in other groups may be omitted or be decision-based on risk stratification.

scholarly journals A new clinical cut-off of cytokeratin 19 mRNA copy number in sentinel lymph node better identifies patients eligible for axillary lymph node dissection in breast cancer

2014 ◽  
Vol 67 (8) ◽  
pp. 702-706 ◽  
Author(s):  
Cristina Deambrogio ◽  
Isabella Castellano ◽  
Alessia Paganotti ◽  
Elisabetta Omodeo Zorini ◽  
Fabio Corsi ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Copy Number ◽  
Axillary Dissection ◽  
Cytokeratin 19 ◽  
Axillary Lymph ◽  
Mrna Copy Number ◽  
Ck19 Mrna ◽  
Intraoperative Management ◽  
Osna Assay

AimsCytokeratin 19 (CK19) mRNA copy number predicts the probability of tumour load in axillary lymph nodes (ALN) and can help in decision-making regarding the axillary dissection. The purpose of this study was to define a new cut-off of CK19 mRNA copy number using the one-step nucleic acid amplification (OSNA) assay on metastatic sentinel lymph nodes (SLN) in order to identify cases at risk of having one or more positive ALN.Methods1296 SLN from 1080 patients were analysed with the OSNA assay. 194 patients with positive SLN underwent ALN dissection and the mean value of CK19 copy number (320 000) of their SLN was set as initial cut-off. Receiver operative characteristics curve identify a best cut-off of 7700 (sensitivity 78%, specificity 57%). A comparison between our and the traditional cut-off (5000) was performed.ResultsThe cut-off of 7700 successfully identifies patients with positive ALN (p=0.001, false- negative cases: 17%). In the range between 5000 and 7700, one patient with positive ALN would not undergo axillary dissection, whereas eight patients with negative ALN would be correctly identified.ConclusionsWe suggest that the level of CK19 mRNA copy number could be the only parameter to consider in the intraoperative management of the axilla.

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