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Intraoperative determination of axillary node metastasis by RT-PCR |
Bulletin du Cancer. Volume 1, Number 1, Mai 2009, Synthèse
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 Résumé
Texte intégral
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Author(s) : M-C Baranzelli, F Penault-Llorca, F Revillon, G Portefaix, F Mishellany, M-P Chauvet, S Giard, M-M Dauplat, P Gimbergues, Y-M Robin, J Dauplat, J Bonneterre |
Summary : The intraoperative determination of axillary node micrometastasis according to the Rapid GeneSearch™ Breast Lymph Node (BLN) is based on RT-PCR (mRNA of mammaglobine and CK19) detects metastases > 0.2 mm.Patients and methodsEighty-three pts between November 2007 and June 2008 were included (33 from Centre Jean-Perrin and 50 from Centre Oscar-Lambret). Lymph nodes were cut in 2 mm slices, and 1 out of 2 was examined with BLN\; the others were examined by imprints then histological exam with immunohistochemistry.ResultsForteen pts had micro- or macrometastasis. Seven were positive with intraoperative imprints including six macrometastasis and one micrometastasis\; seven were positive with BLN and seven at histological exam with two cases of discordance. Sensitivity was 92%, specificity 98%. Positive predictive value 92%, and negative predictive value 98%. The median time for intraoperative determination was 40 minutes for 2 SLN.DiscussionHalf each lymph node is study by each method. This explains the discordances observed. Limit of BLN is the absence of CTI detection\; however there is no consensus about the necessity of axillary clearance in such a case.ConclusionIn this series BLN reduces axillary clearance and improves comfort patients. |
Keywords : Sentinel lymph node, intraoperative exam, breast carcinoma, RT-PCR |
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