Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 25, No 18S (June 20 Supplement), 2007: 21120
© 2007 American Society of Clinical Oncology

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Abstract

Breast cancer submicrometastasis detection in sentinel lymph node by molecular biology techniques: A new tumor staging method?

CEMIC, Buenos Aires, Argentina

21120

Background: The purpose of this study was to analyze by molecular biology techniques (MBT) the presence of RNAm of mammaglobin (MAG) A and B in breast sentinel lymph nodes (SLN) by RT-PCR, and to correlate these findings with breast tumor characteristics. Methods: SLN from 51 patients with breast tumors smaller than or equal to 3 cm, with no palpable axillary lymphadenopathies were included. Hematoxylin-eosin (HE), immunohistochemistry study (IHC) and MBT were performed. Patients’ staging was assessed according to Saint Gallen's Consensus. Twenty-five patients had clinical follow-up. Results: HE showed metastasis in 4/51 cases, 5/51 were detected with IHC, and one of them negative for HE. MBT allowed the detection of 18/51 positive SN, which included the 5 above-mentioned cases. The other lymph nodes herein studied (33/51) showed no metastases with MBT. Patients’ mean age was 58 years, tumor's mean size was 0.96 cm. The average follow-up was 15 months (range: 1–29 months). The patient with a recurrence at 23 months of clinical follow-up was found to be the only one with HE (+), IHC (+), MAG-A (+) and MAG-B (+). Conclusions: SN study with HE fails to identify all SN with metastases. Immunohistochemistry and MBT increase metastasis detection. Multiplex RT-PCR technique for A and B MAG proves to be specific and sensitive. No direct relationship was found between the risk factors analyzed and the expression of MAG. Therefore, MAG could be used independently as a prognostic factor. The presence of hidden metastasis plays a significant role mainly in the overall survival rate of pre- and postmenopausal patients. This study will be useful to formulate hypotheses. Further research, including a larger population and a longer follow-up period, will be required to confirm these hypotheses. Should our findings be confirmed in the future, molecular biology determinations could modify patients staging and treatment.

No significant financial relationships to disclose.