Journal of Clinical Oncology, 2008 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 26, No 15S (May 20 Supplement), 2008: 22079
© 2008 American Society of Clinical Oncology

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Abstract

Detection of sentinel lymph node micrometastases of breast carcinoma by molecular biology

Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina

22079

Background: The prognosis in individuals with breast carcinoma depends on optimal tumor resection margins and axillary lymph node status. The aim of the present study is to evaluate by molecular biology, the presence of Mammaglobin (MAG) A and B messenger RNA, in breast sentinel lymph node (SNL) and to correlate these findings with the characteristics of the primary breast tumor. This correlation would allow us to identify a subset of patients at higher risk of developing axillary nodes metastases. Methods: Between June 2004 and June 2007, 45 SLN from patients with breast carcinoma (less and/or equal to 3cm, without palpable axillary lymphadenopathies) were prospectively studied. Intraoperative evaluation was performed. Defer studies included HE, IHC and molecular biology (MB). Clinical follow-up was also obtained from chart review. Results: The defer study with routine HE sections showed evidence of metastases in 4 cases. Neoplastic cells were detected in 8 cases by IHC. Twenty-one SLN were detected with MB. The rest of the SLN studied (22/45) failed to show evidence of metastases. No significant differences were seen among women with positive and negative SLN byHE-IHC-MB, regarding the age at diagnosis, age of menarche, hormonal status (pre o postmenopause), family or personal medical history, pregnancy and delivery, carcinoma in the contralateral breast, months of follow-up, tumor subtype and histologic grade, tumor size, surgical margins, hormonal receptors and HER2-neu status, vascular invasion and low, intermediate and high risk classification according to Saint Gallen Consensus. Conclusions: The study of SLN with routine HE stained sections is insufficientfor identifying all the cases with micrometastases. Additional IHC and MB studies increase the sensitivity in micrometastases detection. MAG could be a possible independent prognostic factor. If our findings are verified in the future, MB results would modify the staging and treatment of patients with breast cancer.

No significant financial relationships to disclose.