Is the one-step nucleic acid amplification assay better for intra-operative assessment of breast sentinel nodes?

Bettington, Mark, Lakhani, Sunil R. and Ung, Owen A. (2014) Is the one-step nucleic acid amplification assay better for intra-operative assessment of breast sentinel nodes?. ANZ Journal of Surgery, 84 10: 725-729. doi:10.1111/ans.12497


Author Bettington, Mark
Lakhani, Sunil R.
Ung, Owen A.
Title Is the one-step nucleic acid amplification assay better for intra-operative assessment of breast sentinel nodes?
Journal name ANZ Journal of Surgery   Check publisher's open access policy
ISSN 1445-2197
1445-1433
Publication date 2014-10-01
Year available 2014
Sub-type Article (original research)
DOI 10.1111/ans.12497
Volume 84
Issue 10
Start page 725
End page 729
Total pages 5
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Language eng
Formatted abstract
Background

Intra-operative assessment of sentinel lymph nodes in breast cancer offers the opportunity to prevent two-stage surgical procedures. At our institution we employ touch imprint cytology (TIC), which lacks sensitivity. In this study we compare the one-step nucleic acid amplification (OSNA) assay to TIC.

Methods

Imprints were taken from 63 lymph nodes from 35 patients. The lymph nodes were sectioned at 2-mm intervals and alternate slices submitted for either histology or OSNA assay, with histology as the reference standard.

Results

Seven patients were histologically positive. Nine and five patients were positive by OSNA and TIC, respectively. Sensitivity, specificity, positive and negative predictive value for the OSNA assay were 85.7%, 85.7%, 63.6% and 96.6% and for TIC were 70.0%, 96.6%, 87.5% and 90.3%.

Conclusion

In this study OSNA had a higher sensitivity than TIC. Fewer patients assessed by the OSNA assay would have required a two-stage procedure. The OSNA assay appears to be a highly cost-effective method for providing rapid and reliable intra-operative assessment of sentinel lymph nodes.
Keyword Axilla
Breast cancer
Cytology
Hospital economics
Sentinel lymph node biopsy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2015 Collection
School of Medicine Publications
 
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Created: Tue, 31 Mar 2015, 20:40:07 EST by Roheen Gill on behalf of Medicine - Royal Brisbane and Women's Hospital