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
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...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-07-01
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| Series: | Clinical Pathology |
| Online Access: | https://doi.org/10.1177/2632010X231183693 |
| _version_ | 1797768045539622912 |
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| author | L Bernet D Hardisson M Rodrigo A Córdoba M Sancho V Peg I Ruiz F Godey JI Sánchez-Méndez A Prat |
| author_facet | L Bernet D Hardisson M Rodrigo A Córdoba M Sancho V Peg I Ruiz F Godey JI Sánchez-Méndez A Prat |
| author_sort | L Bernet |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-12T20:48:50Z |
| format | Article |
| id | doaj.art-12c8d1e303ad4da3ac501785fdbfba7c |
| institution | Directory Open Access Journal |
| issn | 2632-010X |
| language | English |
| last_indexed | 2024-03-12T20:48:50Z |
| publishDate | 2023-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical Pathology |
| spelling | doaj.art-12c8d1e303ad4da3ac501785fdbfba7c2023-08-01T07:03:21ZengSAGE PublishingClinical Pathology2632-010X2023-07-011610.1177/2632010X231183693OSNA 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 StudyL Bernet0D Hardisson1M Rodrigo2A Córdoba3M Sancho4V Peg5I Ruiz6F Godey7JI Sánchez-Méndez8A Prat9Department of Pathology, Hospital Universitario del Vinalopó, Elche, SpainHospital La Paz Institute for health Research (IdiPAZ), Universidad Autónoma de MadridDepartment of Pathology, Hospital Universitario de Burgos, Burgos, SpainDepartment of Pathology, Hospital Universitario de Navarra, Navarra, SpainDepartment of Pathology, Hospital Universitario de Salamanca, Salamanca, SpainSpanish Biomedical Research Network Centre in Oncology (CIBERONC), Madrid, SpainDepartment of Pathology, Hospital Universitario de Donostia, Donostia, SpainDepartment of Pathology, Centre Eugène Marquis, Rennes, FranceHospital La Paz Institute for Health Research (IdiPAZ), Universidad Autónoma de MadridMedical Oncology department, Hospital Clínic de Barcelona, Barcelona, SpainAims: 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.https://doi.org/10.1177/2632010X231183693 |
| spellingShingle | L Bernet D Hardisson M Rodrigo A Córdoba M Sancho V Peg I Ruiz F Godey JI Sánchez-Méndez A Prat 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 Clinical Pathology |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | https://doi.org/10.1177/2632010X231183693 |
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