CK19 expression in breast tumours and lymph node metastasis after neoadjuvant therapy

Vieites, Begoña; López-García, María Ángeles; Castilla, Carolina; Hernández, María José; Biscuola, Michele; Alfaro, Lina; Atienza, M.; Castilla, María Ángeles; Palacios, José

doi:10.1111/his.12924

Cited by 12 publications

(6 citation statements)

References 39 publications

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“…Their evidence comparing breast tumor and node samples before and after NAC found that the CK19 mRNA was preserved. 34 Parada et al had similar findings last year from an institutional study of 50 patients undergoing SLN analysis and OSNA following NAC. 35 Of those patients with “positive SLN’s” (ITC as well as micro- and macro-metastases), all were subject to ALND.…”

Section: Breast Cancer Overviewmentioning

confidence: 57%

One-step nucleic acid amplification: the possible value in assessing sentinel lymph node metastasis during mastectomy

Hunter-Smith¹,

Rayter²

2018

BCTT

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Breast cancer is the most common cancer in women, worldwide, and 1,400 deaths per day are attributed to it. The success of national screening programs has seen breast cancers being diagnosed at an earlier stage. With conservative surgery to the breast demonstrating equivalent long-term outcomes, the last 10 years have seen a growing interest in the safety of less invasive management for the axilla in breast cancer patients. One-step nucleic acid amplification (OSNA) is a validated, reliable, and efficient tool in identifying micro- and macro-metastases intraoperatively. It is the most widely used intraoperative analysis tool within the United Kingdom, and is employed by over 320 units across Europe and Asia. Recent evidence from the AMAROS, IBCSG 23-01, and ACOSOG Z0011 trials has changed surgical practice in managing the axilla of patients with breast cancer. We propose a clinical algorithm demonstrating the role of OSNA as an intraoperative analysis tool in today’s management of breast cancer as well as prospects for the future use of OSNA.

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Section: Breast Cancer Overviewmentioning

confidence: 57%

One-step nucleic acid amplification: the possible value in assessing sentinel lymph node metastasis during mastectomy

Hunter-Smith¹,

Rayter²

2018

BCTT

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“…All the patients who underwent neoadjuvant chemotherapy were excluded. Currently, the OSNA method after neoadjuvant therapy has some validation studies [ 9 , 10 , 11 , 12 ]. The national guidelines on which our clinical pathway is based and this study do not provide the use of the OSNA method for all those patients who underwent neoadjuvant chemotherapy.…”

Section: Methodsmentioning

confidence: 99%

“…The main problem using the ONSA method after neoadjuvant treatment is that the evaluation of histological lymph nodal asset after secondary treatment is lost. Moreover, the lymph node remnant after treatment is the only neoplastic cells residual from the entire surgery, resulting lost the opportunity for the immunohistochemical study [ 9 , 10 , 11 , 12 ]. Therefore, we had to exclude all those patients.…”

Section: Methodsmentioning

confidence: 99%

Axillary Treatment Management in Breast Cancer during COVID-19 Pandemic (Association between ACOSOG Z0011 Criteria and OSNA Test)

Anedda

Cappellacci

Canu

et al. 2023

JPM

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The outbreak of the SARS-COVID-2 pandemic (COVID-19) had a significant effect on the organisation of healthcare systems. Surgical units saw a significant reduction in the volume of surgical procedures performed, with lengthening waiting lists as a consequence. We assessed the surgical activity in relation to breast cancer that took place at the University Hospital of Cagliari, Italy, from February 2018 to March 2022. Two phases were identified based on the epidemiological circumstances: Phase 1—February 2018 to February 2020; Phase 2—March 2020 to March 2022. The surgery performed in the two phases was then compared. All the patients in our sample underwent a breast surgical procedure involving a lymph node biopsy using OSNA associated with the ACOSOG Z0011 criteria. In the study period overall at our facility, there were 4214 procedures, 417 of which involved breast surgery. In Phase 2, 91 procedures were performed using the OSNA method and ACOSOG Z0011 criteria, enabling the intraoperative staging of axillary nodes. Axillary treatment in breast cancer using this approach resulted in a significant reduction in the number of reoperations for the radicalisation of metastatic sentinel lymph nodes.

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“…One Step Nucleic acid Amplification (OSNA) is a molecular technique that allows the detection of the number of copies of messenger Ribonucleic Acid (mRNA) of cytokeratin 19 (CK19) present in the sentinel lymph node (SLN). CK19 is a membrane protein expressed by most breast carcinomas even after NAST, constituting a good target to detect BC metastasis [ 10 , 11 ].The calculation of the total tumor load (TTL) based on CK19 mRNA copy number is a highly sensitive and specific method for the detection of micro and macrometastasis of lymph nodes (LNs) [ 12 , 13 ]. TTL is a quantitative index that provides information on the metastatic load present in the LNs, in an objective manner.…”

Section: Introductionmentioning

confidence: 99%

Value of total tumor load as a clinical and pathological factor in the prognosis of breast cancer patients receiving neoadjuvant treatment. Comparison of three populations with three different surgical approaches: NEOVATTL Pro 3 Study

Martín-Salvago

Sancho

López-García

et al. 2023

Breast Cancer Res Treat

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Purpose This study aimed to compare the prognosis in terms of disease-free survival (DFS) in three populations of women with breast cancer (BC) treated with neoadjuvant systemic treatment (NAST) in which axillary lymph node dissection (ALND) was performed based on different total tumor load (TTL) thresholds in the sentinel nodes. Methods This was an observational, retrospective study carried out in three Spanish centers. Data from patients with infiltrating BC who underwent BC surgery after NAST and intraoperative sentinel lymph node biopsy (SLNB) performed by One Step Nucleic acid Amplification (OSNA) technique during 2017 and 2018 were analyzed. ALND was performed according to the protocol of each center, based on three different TTL cut-offs (TTL > 250, TTL > 5000, and TTL > 15,000 CK19-mRNA copies/μL for centers 1, 2, and 3, respectively). Results A total of 157 BC patients were included in the study. No significant differences in DFS were observed between centers (Hazard ratio [HR] center 2 vs 1: 0.77; p = 0.707; HR center 3 vs 1: 0.83; p = 0.799). Patients with ALND had a shorter DFS (HR 2.43; p = 0.136), albeit not statistically significant. Patients with a triple negative subtype had a worse prognosis than those with other molecular subtypes (HR 2.82; p = 0.056). Conclusion No significant differences in DFS were observed between three centers with different surgical approaches to ALND based on different TTL cut-offs in patients with BC after NAST. These results suggest that restricting ALND to those patients with TTL ≥ 15,000 copies/μL is a reliable approximation, avoiding unnecessary morbidities caused by ALND.

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CK19 expression in breast tumours and lymph node metastasis after neoadjuvant therapy

Cited by 12 publications

References 39 publications

One-step nucleic acid amplification: the possible value in assessing sentinel lymph node metastasis during mastectomy

One-step nucleic acid amplification: the possible value in assessing sentinel lymph node metastasis during mastectomy

Axillary Treatment Management in Breast Cancer during COVID-19 Pandemic (Association between ACOSOG Z0011 Criteria and OSNA Test)

Value of total tumor load as a clinical and pathological factor in the prognosis of breast cancer patients receiving neoadjuvant treatment. Comparison of three populations with three different surgical approaches: NEOVATTL Pro 3 Study

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