1. OSNA Total Tumor Load for the Prediction of Axillary Involvement in Breast Cancer Patients: Should We use Different Thresholds According to the Intrinsic Molecular Subtype? MOTTO Study.
- Author
-
Bernet, L, Hardisson, D, Rodrigo, M, Córdoba, A, Sancho, M, Peg, V, Ruiz, I, Godey, F, Sánchez-Méndez, JI, and Prat, A
- Subjects
- *
BREAST cancer prognosis , *STATISTICS , *CONFIDENCE intervals , *AXILLA , *IMMUNOHISTOCHEMISTRY , *MULTIVARIATE analysis , *METASTASIS , *CANCER relapse , *ACQUISITION of data , *CANCER patients , *RISK assessment , *MESSENGER RNA , *MEDICAL records , *DESCRIPTIVE statistics , *SURVIVAL analysis (Biometry) , *RESEARCH funding , *TUMOR markers , *SENTINEL lymph nodes , *PROGRESSION-free survival , *LOGISTIC regression analysis , *STATISTICAL models , *ODDS ratio , *DATA analysis software , *OVERALL survival , *AXILLARY lymph node dissection , *NUCLEIC acid amplification techniques , *PROPORTIONAL hazards models , *HORMONE receptor positive breast cancer , *DISEASE risk factors - Abstract
Aims: To assess the impact of the molecular subtype (MS) on the total number of CK19 mRNA copies in all positive SLN (TTL) threshold, to predict non-SLN affectation, and to compare 5 years progression-free survival (PFS) according to the risk of recurrence (ROR) group by PAM50. Methods: Cohort with infiltrating breast cancer with intra-operative metastatic SLN detected by one-step nucleic acid amplification (OSNA) assay who underwent subsequent ALND. Logistic regression was used to assess a possible interaction between TTL and MS(Triple Negative, Her-2-Enriched, Luminal A, or Luminal B), or hormone receptors (HR: positive or negative) by immunohistochemistry (IMH). Cox regression was used to compare PFS and OS in the 3 ROR groups (high, medium, or low). Results: TTL was predictive of non-SLN affectation in both univariate (OR [95% CI]: 1.72 [1.43, 2.05], P <.001) and multivariate (1.55 [95% CI: 1.04, 2.32], P =.030) models, but MS-IMH or HR-IMH, and their interactions with TTL were not (best multivariate model: HR + main effect OR 1.16 [95% CI: 0.18, 7.64], P =.874; interaction OR: 1.04 [0.7, 1.55], P =.835; univariate model: HR + main effect OR: 1.44 [95% CI: 0.85, 2.44], P =.180). PFS was lower in the high-risk ROR group (81.1%) than in the low-risk group (93.9%) (HR: 3.68 [95 CI: 1.70, 7.94], P <.001). Conclusions: our results do not provide evidence to support the utilization of subtype-specific thresholds for TTL values to make therapeutic decisions on the axilla. The ROR group was predictive of 5 years-PFS. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF