Sentinel node biopsy in breast cancer: Comparison between post-operative histologic exam, intraoperative histologic exam and one-step-nucleic acid amplification (OSNA) analysis

Experts Meeting on Gynecologic Oncology

May 19-21, 2016 San Antonio, USA

Cedolini Carla

University of Udine, Italy

Posters & Accepted Abstracts: J Cancer Sci Ther

Abstract :

Introduction: Sentinel node (SN) biopsy is still a fundamental step of breast surgery. In the last years, the amount of tumor burden in SN is matter of debate and the axillary dissection in case of micrometastases and even of some cases of macrometastases is changing its role. Materials & Methods: We realized a retrospective cohort study with 3 different groups of patients: In group A, we analyzed sentinel node post-operative with histologic exam, in group B the sentinel node was analyzed with intraoperative histologic exam and in group C we used OSNA (One-Step-Nucleic Acid Amplification) technique. We selected only patients with T1 and T2 infiltrative carcinomas (DCI and LCI) that underwent either breast conservative surgery or mastectomy. In case of ITC (Isolated Tumor Cells) in the SN, we didnâ��t perform an axillary dissection while in case of micrometastasis and macrometastasis, a 1�°, 2�° and 3�° level dissection was done. We also analyzed time and cost of the 3 different procedures and we also compared Overall Survival (OS), Disease Free Survival (DFS), Cumulative Loco-Regional Recurrence (CLRR) and Cumulative Distant Metastases (CDM) at 2 years of follow-up. Results: We collected 450 patients in group A, 427 in group B and 406 in group C. BCS was performed in 65% of women, while mastectomy was done in 35% of cases. The SN was overall positive in 22.5% of patients (20.7% in group A, 18.5% in group B, 28.8% in group C). The rate of micrometastasis was respectively 5.6%, 4.4% and 12.1% in the 3 groups. The mean time of OSNA analysis was 42 minutes per patient and it was the fastest method. OSNA method was more expensive than intraoperative histologic analysis but if you consider also the operating theatreâ��s cost itâ��s cheaper. There was no difference in OS, DFS, CLRR and CDM. Discussion: In group B and C we found a higher percentage of micrometastasis, in accordance with the major published studies. We have to correlate these data with the new role of axillary dissection in order to decide in which case itâ��s necessary to perform it or not.

Biography :

Email: cedolini.carla@aoud.sanita.fvg.it