Isolated tumour cells and micrometastases in intraductal breast cancer: a simple mechanical question in some cases

Reply: Isolated tumour cells and micrometastases in intraductal breast cancer: a simple mechanical question in some cases

“…We appreciate the data and comments provided by Piñero-Madrona et al (2013) regarding our recent publication (Osako et al , 2012). In our study, we showed that the number of patients with a postoperative diagnosis of ductal carcinoma in situ (DCIS; intraductal breast cancer) and sentinel lymph node (SN) metastasis increased significantly after the introduction of molecular whole-node analysis using the one-step nucleic acid amplification (OSNA) assay for SN biopsies.…”

“…In our study, we showed that the number of patients with a postoperative diagnosis of ductal carcinoma in situ (DCIS; intraductal breast cancer) and sentinel lymph node (SN) metastasis increased significantly after the introduction of molecular whole-node analysis using the one-step nucleic acid amplification (OSNA) assay for SN biopsies. Piñero-Madrona et al (2013) also presented a case series of DCIS with SN metastasis detected using the OSNA assay. Their study gave similar results to ours as they showed that the OSNA assay was able to detect SN micrometastasis in DCIS and that there were <1500 copies of cytokeratin 19 mRNA per microlitre.…”

“…Therefore, as a possible explanation for the pathogenesis of nodal metastases in DCIS, we propose that true metastases arise from the occult invasion of the primary tumour and iatrogenic dissemination of benign epithelial or tumour cells during preoperative breast biopsy (Osako et al , 2012). On the basis of their findings, Piñero-Madrona et al (2013) also advocate the theory of iatrogenic dissemination resulting from preoperative needle biopsy.…”