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Test may eliminate need for unnecessary axillary node dissection in breast cancer
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A new real-time-PCR assay done on sentinel lymph nodes during primary breast tumor ressection had high predictive value for axillary metastases and may help reduce the need for second surgery in patients with breast cancer, according to data presented at IMPAKT Breast Cancer Conference.
"The process of trying to identify micrometastases takes a lot of time and money," Martine Piccart, MD, PhD, conference co-chair and associate professor of oncology at the Jules Bordet Institute in Brussels, Belgium, said in a press release. "The new technique allows you to make the diagnosis of micrometastases while the surgery is underway, meaning the patient does not have to suffer the disruption of undergoing another operation."
Researchers used a molecular assay (GeneSearch, Veridex) to test sentinel nodes from 1,138 patients at sites in the United States, Belgium and the United Kingdom. The molecular assay was compared with traditional permanent section histology.
The turnaround time to result for the assay was approximately 30 to 40 minutes. Sentinel lymph node positivity rates were 30% for the assay and 26% for histology, according to the researchers. The assay yielded a 96% negative predictive value vs. 90% with histology; when the two methods were combined they had a 99% negative predictive value.
Only 1.6% of patients who tested negative on the assay were positive on the histology.
"The data to date indicate the intraoperative assay result is as accurate as permanent section histology on sentinel lymph nodes for predicting nonsentinel lymph node status, even when histology is negative," the researchers said.
For more information:
- Larsimont D. #400. Presented at: IMPAKT Breast Cancer Conference; May 7-9, 2009; Brussels, Belgium.