An improved axillary staging system using the OSNA assay does not modify the therapeutic management of breast cancer patients

• Published in: Scientific reports 2014-07, Vol.4 (1), p.5743-5743, Article 5743
• Main Authors: Ruano, Miguel Alonso, Lopez-Bonet, Eugeni, Buxó, Maria, Tuca-Rodríguez, Francesc, Vila-Camps, Ester, Alvarez, Elena, Martin-Castillo, Begoña, Menendez, Javier A.
• Format: Article
• Language: English
• Subjects: 13; 13/56; 38; 38/77; 692/420/755; 692/499; 692/699/67/1347; 692/700/565/1436/99; Adult; Aged; Axilla; Biopsy; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - genetics; Breast Neoplasms - pathology; Carcinoma, Ductal, Breast - drug therapy; Carcinoma, Ductal, Breast - genetics; Carcinoma, Ductal, Breast - secondary; Chemotherapy, Adjuvant; Female; Humanities and Social Sciences; Humans; Immunohistochemistry; Lymph; Lymph nodes; Lymph Nodes - pathology; Lymphatic Metastasis; Metastases; Middle Aged; Molecular Diagnostic Techniques; multidisciplinary; Neoplasm Staging - methods; Nucleic Acid Amplification Techniques; Nucleic acids; Quality Improvement; Science; Science (multidisciplinary); Statistical analysis; Tumor cells
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/srep05743

The one-step nucleic acid amplification (OSNA) assay is a molecular procedure that can identify deposits of breast cancer (BC) cells in the sentinel lymph node (SLN). We examined the consistency of the OSNA assay with a classic hematoxylin-eosin (H&E)-based immunohistochemistry (IHC) study and evaluated how OSNA-based axillary staging might impact the therapeutic management of BC patients. SLN biopsy results were considered to be positive in 60 patients (40%) in the OSNA group (N = 148) and in 43 (28%) patients in the IHC cohort (N = 153, p = 0.023). There was no difference in the macrometastasis (22% for OSNA, 15% for H&E, p = 0.139) or micrometastasis (19% for OSNA, 13% for H&E, p = 0.166) rates, but we found statistically significant differences in the number of isolated tumor cells (1% for OSNA, 11% for H&E, p < 0.001). There were no differences in the administration rate of adjuvant systemic therapy between the OSNA (66% in the SLN + patients) and the H&E (74% in the SLN + patients) groups (p = 0.159). The OSNA assay allows for the detection of SLN metastases more precisely than conventional pathologic methods but does not alter the therapeutic management of SLN + BC patients.