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- Title
A New Possible Cut-Off of Cytokeratin 19 mRNA Copy Number by OSNA in the Sentinel Node of Breast Cancer Patients to Avoid Unnecessary Axillary Dissection: A 10-Year Experience in a Tertiary Breast Unit.
- Authors
Tomasicchio, Giovanni; Mastropasqua, Mauro Giuseppe; Picciariello, Arcangelo; Montanaro, Alda Elena; Signorile, Daniela; Cirilli, Alfredo; Punzo, Clelia
- Abstract
Simple Summary: This manuscript aims to investigate the features of patients with metastatic sentinel lymph node (SLN), evaluated by OSNA, and to predict which patients have a high risk of positive ALND. The finding of the present study suggests a new cut-off of CK19 mRNA copy number in the sentinel lymph node useful to personalize surgical treatments and avoid unnecessary axillary surgical treatments. (1) Background: The main discriminant in breast cancer prognosis is axillary lymph node status. In a select cohort of patients, axillary lymph node dissection (ALND) may be safely spared. This study aimed to determine a new possible cut-off of cytokeratin (CK) 19 mRNA copy number in the SLN to predict cases at high risk of positive ALND. (2) Methods: Clinical records of 1339 patients were retrospectively reviewed and were separated into two groups according to the axillary status (negative: ALNs− and positive ALNs+). Receiver operative characteristic (ROC) curves were used to identify a new optimal cut-off of CK19 mRNA copy number in SLN; (3) Results: Large tumor size and high grade were found mostly in ALNs+. Results from the ROC analyses, with an AUC of 82.1%, identified a new cut-off (9150 CK19 mRNA copies) showing 94% sensitivity, 67.3% specificity, 61.2% positive, and 95.3% negative predictive values; (4) OSNA remains the most-important intra-operative tool to identify patients who can benefit from ALND but with the traditional cut-off, many patients undergo needless ALND. The results of the present study suggest a new cut-off helpful to personalize surgical treatment and avoid unnecessary invasive procedures.
- Subjects
CYTOSKELETAL proteins; UNNECESSARY surgery; RETROSPECTIVE studies; CANCER patients; RISK assessment; MESSENGER RNA; DESCRIPTIVE statistics; SENTINEL lymph nodes; RECEIVER operating characteristic curves; SENSITIVITY &; specificity (Statistics); BREAST tumors; AXILLARY lymph node dissection
- Publication
Cancers, 2022, Vol 14, Issue 14, pN.PAG
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers14143384