Accession Number : ADA390075


Title :   Accuracy and Significance of Polymerase Chain Reaction Detection of Sentinel Node Metastases in Breast Cancer Patients


Descriptive Note : Annual rept. 1 Oct 1999-30 Sep 2000


Corporate Author : EAST CAROLINA UNIV GREENVILLE NC


Personal Author(s) : Verbanac, Kathryn M ; Tafra, Lorraine


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a390075.pdf


Report Date : Oct 2000


Pagination or Media Count : 104


Abstract : Sentinel lymph node biopsy (SLNB) was evaluated in 535 breast cancer patients in a multi-center trial using a combination of isosulfan blue and technetium sulfur colloid to: (1) determine if the SLN accurately predicts the disease in the remaining axilla; (2) identify factors that affect the success and false negative rate; (3) identify molecular markers to assess the prognostic value of detecting SLN micrometastatic disease using RT-PCR. SLNB by experienced surgeons can detect the SLN in 90% patients, with a false negative rate 5%. Only patient age 50 years and surgical experience 30 cases increased failure and false negative rates. Prior surgery, tumor size/location, vascular/lymphatic invasion, or method of diagnosis had no effect. The optimal timing of Tc99 injection (1-5 hrs) and injection site (intradermal and combination of sites appear superior) were investigated. Analysis of 154 SLN from 87 patients indicates that mammaglobin and CEA, alone or in combination, are highly specific (undetectable or trace levels in normal LN), highly accurate (detect tumor cells in 84-97% breast cancer patients) and highly sensitive (detect occult disease and potentially upstage 25-44% histology-negative patients) markers. There was a 73% concordance rate in mammaglobin and CEA expression. Marker expression correlated with tumor size and ER status.


Descriptors :   *BIOPSY , *BREAST CANCER , *DIAGNOSIS(MEDICINE) , *LYMPH NODES , ACCURACY , CARDIOVASCULAR SYSTEM , CELLS(BIOLOGY) , CHAIN REACTIONS , DETECTION , LYMPHATIC SYSTEM , MARKERS , MOLECULES , NEOPLASMS , OCCULTATION , PATIENTS , POLYMERIZATION , POSITION(LOCATION) , SIZES(DIMENSIONS) , SULFUR , SURGERY , TECHNETIUM


Subject Categories : Anatomy and Physiology
      Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE