Journal article
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
Annals of surgical oncology, Vol.17(S3), pp.312-320
10/2010
DOI: 10.1245/s10434-010-1258-y
PMID: 20853052
Abstract
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.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.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.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.
Details
- Title: Subtitle
- 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
- Creators
- Carla Fisher - Department of Surgery Medical University of South Carolina Charleston SC USADavid Cole - Department of Surgery Medical University of South Carolina Charleston SC USAMichael Mitas - Department of Hematology and Oncology Medical University of South Carolina Charleston SC USAElizabeth Garrett-Meyer - Department of Biostatistics Medical University of South Carolina Charleston SC USAJohn Metcalf - Department of Pathology Medical University of South Carolina Charleston SC USAWilliam Gillanders - Department of Surgery Washington University St. Louis MO USAKaidi Mikhitarian - Department of Pathology and Anatomical Sciences University of Missouri Columbia MO USAMarshall Urist - Department of Surgery University of Alabama Birmingham AL USAG Mann - Department of Surgery, Royal Melbourne Hospital The University of Melbourne Melbourne VIC AustraliaGerard Doherty - Department of Surgery University of Michigan Ann Arbor MI USAVirginia Herrmann - Department of Surgery Beaumont Hospital Dublin IrelandArnold Hill - Department of Surgery Beaumont Hospital Dublin IrelandOleg Eremin - Department of Surgery Lincoln County Hospital Lincoln England, UKMohamed El-Sheemy - Department of Surgery Lincoln County Hospital Lincoln England, UKRichard Orr - Gibbs Regional Cancer Center Spartanburg SC USAAlvaro Valle - Department of Surgery University of Tennessee Chattanooga TN USAMichael Henderson - Department of Surgery St. Vincent’s Hospital Fitzroy VIC AustraliaRobert Dewitty - Howard University Cancer Center Washington DC USASonia Sugg - Department of Surgery University of Iowa Iowa City IA USAEric Frykberg - Department of Surgery University of Florida Jacksonville FL USAKaren Yeh - Department of Surgery Medical College of Georgia Augusta GA USARichard Bell - Department of Surgery University of South Carolina Columbia SC USAMegan Baker - Department of Surgery Medical University of South Carolina Charleston SC USA
- Resource Type
- Journal article
- Publication Details
- Annals of surgical oncology, Vol.17(S3), pp.312-320
- Publisher
- Springer-Verlag; New York
- DOI
- 10.1245/s10434-010-1258-y
- PMID
- 20853052
- ISSN
- 1068-9265
- eISSN
- 1534-4681
- Language
- English
- Date published
- 10/2010
- Academic Unit
- Surgery
- Record Identifier
- 9984051706202771
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