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Annals of Surgical Oncology
Erschienen in: Annals of Surgical Oncology 3/2010

01.10.2010 | American Society of Breast Surgeons

Molecular Detection of Micrometastatic Breast Cancer in Histopathology—Negative Axillary Lymph Nodes Fails to Predict Breast Cancer Recurrence: A Final Analysis of a Prospective Multi-Institutional Cohort Study

verfasst von: Carla Suzanne Fisher, MD, David J. Cole, MD, Michael Mitas, PhD, Elizabeth Garrett-Meyer, PhD, John S. Metcalf, MD, William E. Gillanders, MD, Kaidi Mikhitarian, MD, Marshall M. Urist, MD, G. Bruce Mann, MD, Gerard Doherty, MD, Virginia M. Herrmann, MD, Arnold D. Hill, MD, Oleg Eremin, MD, Mohamed El-Sheemy, MD, PhD, Richard K. Orr, MD, Alvaro A. Valle, MD, Michael A. Henderson, MD, Robert L. Dewitty, MD, Sonia L. Sugg, MD, Eric Frykberg, MD, Karen Yeh, MD, Richard M. Bell, MD, Megan K. Baker, MD

Erschienen in: Annals of Surgical Oncology | Sonderheft 3/2010

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Abstract

Background

To address the clinical relevance of molecular detection of occult breast cancer in sentinel lymph nodes and nonsentinel axillary lymph nodes (ALN), we initiated the Minimally Invasive Molecular Staging of Breast Cancer (MIMS) trial, a multi-institutional prospective cohort study. This trial represents the first prospective cohort study in which a multimarker, real-time reverse transcription polymerase chain reaction (RT-PCR) analysis was applied to the detection of breast cancer micrometastases in ALN.

Materials and Methods

Sentinel and/or nonsentinel ALN from 501 breast cancer subjects with T1–T3 primary tumors were analyzed by standard histopathology and multimarker, real-time RT-PCR analysis. Seven breast cancer-associated genes (mam, mamB, PIP, CK19, muc1, PSE, and CEA) known to be overexpressed in metastatic breast cancer compared with control lymph nodes were used. Follow-up data were collected for 5 years.

Results

Of the 501 breast cancer subjects enrolled, 348 were node negative and completed the 5-year follow-up. Of these patients (n = 94), 27% demonstrated evidence of molecular overexpression. The 5-year relapse-free survival rate was 95.4% (95% confidence interval [95% CI], 92.4–97.2%). No single gene or combination of study genes was predictive of recurrence.

Conclusions

The genes in this study panel failed to be predictive of clinical relapse. This may be a function of several factors: the low event rate at 5 years, the particular gene set, the methodology used for detection/analysis or that our original hypothesis was wrong and that the presence of positive marker signal by real-time RT-PCR is not associated with a worsened clinical outcome.
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Metadaten
Titel
Molecular Detection of Micrometastatic Breast Cancer in Histopathology—Negative Axillary Lymph Nodes Fails to Predict Breast Cancer Recurrence: A Final Analysis of a Prospective Multi-Institutional Cohort Study
verfasst von
Carla Suzanne Fisher, MD
David J. Cole, MD
Michael Mitas, PhD
Elizabeth Garrett-Meyer, PhD
John S. Metcalf, MD
William E. Gillanders, MD
Kaidi Mikhitarian, MD
Marshall M. Urist, MD
G. Bruce Mann, MD
Gerard Doherty, MD
Virginia M. Herrmann, MD
Arnold D. Hill, MD
Oleg Eremin, MD
Mohamed El-Sheemy, MD, PhD
Richard K. Orr, MD
Alvaro A. Valle, MD
Michael A. Henderson, MD
Robert L. Dewitty, MD
Sonia L. Sugg, MD
Eric Frykberg, MD
Karen Yeh, MD
Richard M. Bell, MD
Megan K. Baker, MD
Publikationsdatum
01.10.2010
Verlag
Springer-Verlag
Erschienen in
Annals of Surgical Oncology / Ausgabe Sonderheft 3/2010
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1258-y

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