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
(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 predi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/14/3384 |
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| author | Giovanni Tomasicchio Mauro Giuseppe Mastropasqua Arcangelo Picciariello Alda Elena Montanaro Daniela Signorile Alfredo Cirilli Clelia Punzo |
| author_facet | Giovanni Tomasicchio Mauro Giuseppe Mastropasqua Arcangelo Picciariello Alda Elena Montanaro Daniela Signorile Alfredo Cirilli Clelia Punzo |
| author_sort | Giovanni Tomasicchio |
| collection | DOAJ |
| description | (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. |
| first_indexed | 2024-03-09T10:21:34Z |
| format | Article |
| id | doaj.art-bec35fa9f75f40c983f0ec388f7c16e7 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T10:21:34Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
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| series | Cancers |
| spelling | doaj.art-bec35fa9f75f40c983f0ec388f7c16e72023-12-01T21:59:17ZengMDPI AGCancers2072-66942022-07-011414338410.3390/cancers14143384A 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 UnitGiovanni Tomasicchio0Mauro Giuseppe Mastropasqua1Arcangelo Picciariello2Alda Elena Montanaro3Daniela Signorile4Alfredo Cirilli5Clelia Punzo6Department of Emergency and Organ Transplantation, School of Medicine, University of Bari “Aldo Moro”, Piazza G Cesare, 11, 70124 Bari, ItalyDepartment of Emergency and Organ Transplantation, School of Medicine, University of Bari “Aldo Moro”, Piazza G Cesare, 11, 70124 Bari, ItalyDepartment of Emergency and Organ Transplantation, School of Medicine, University of Bari “Aldo Moro”, Piazza G Cesare, 11, 70124 Bari, ItalyBreast Unit Surgery, Azienda Ospedaliera Universitaria Policlinico Bari, Piazza G Cesare, 11, 70124 Bari, ItalyBreast Unit Surgery, Azienda Ospedaliera Universitaria Policlinico Bari, Piazza G Cesare, 11, 70124 Bari, ItalyBreast Unit Surgery, Azienda Ospedaliera Universitaria Policlinico Bari, Piazza G Cesare, 11, 70124 Bari, ItalyDepartment of Emergency and Organ Transplantation, School of Medicine, University of Bari “Aldo Moro”, Piazza G Cesare, 11, 70124 Bari, Italy(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.https://www.mdpi.com/2072-6694/14/14/3384breast cancerbreast pathologybreast surgeryaxillary lymph nodessentinel lymph nodeone-step nucleic acid amplification |
| spellingShingle | Giovanni Tomasicchio Mauro Giuseppe Mastropasqua Arcangelo Picciariello Alda Elena Montanaro Daniela Signorile Alfredo Cirilli Clelia Punzo 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 Cancers breast cancer breast pathology breast surgery axillary lymph nodes sentinel lymph node one-step nucleic acid amplification |
| 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | breast cancer breast pathology breast surgery axillary lymph nodes sentinel lymph node one-step nucleic acid amplification |
| url | https://www.mdpi.com/2072-6694/14/14/3384 |
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