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

Overview

Journal Clin Pathol

Publisher Sage Publications

Date 2023 Aug 3

PMID 37534372

Authors

L Bernet

D Hardisson

M Rodrigo

A Cordoba

M Sancho

V Peg

I Ruiz

F Godey

J I Sanchez-Mendez

A Prat

Affiliations

Soon will be listed here.

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], < .001) and multivariate (1.55 [95% CI: 1.04, 2.32], = .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], = .874; interaction OR: 1.04 [0.7, 1.55], = .835; univariate model: HR + main effect OR: 1.44 [95% CI: 0.85, 2.44], = .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], < .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.

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