Intra-operative molecular diagnosis of sentinel lymph node and prediction of non-sentinel lymph node metastasis in breast cancer patients

摘要

To the Editor: Sentinel lymph node biopsy has become a universal procedure performed in node-negative breast cancer patients. The accurate intra-operative assessment of the sentinel lymph node (SLN) is prominent in enabling axillary lymph node dissection (ALND) synchronously performed during the breast surgery, in case of the morbidity, inconvenience, and extra cost resulting from a second operation. One-step nucleic acid amplification (OSNA) assay (Sysmex, Kobe, Japan) is a moderately sensitive molecular technique combining node tissue homogenization and subsequent reverse-transcription loop-mediated isothermal amplification of cytokeratin-19 (CK-19) mRNA in a single reaction. The assay could accurately discern nodal metastases of over 0.2 mm intra-operatively.