%0 Journal Article
%T RT¨CPCR technique for the intra-operative assessment of breast sentinel lymph nodes ¨C Is this the way forward?
%A Santosh Kumar Somasundaram
%A Alistair Ironside
%A Rachel McCarthy
%A Stephen Davison
%J Journal of Solid Tumors
%D 2011
%I 
%R 10.5430/jst.v1n2p56
%X Background Sentinel lymph node biopsy (SLNB) is the current standard of care for lymphatic staging in early breast cancer patients. The combination of a SLNB with an intra-operative diagnosis of the SLNB enables a single staged procedure, avoiding a delayed axillary lymph node dissection (ALND) in node positive patients. The current conventional pathological techniques are resource intensive, require expert personnel and are not routinely used in many breast units. Methods GeneSearch  BLN assay is a RT-PCR technique calibrated to detect SLN metastases of >0.2mm. It is designed to detect 2 clinically validated genes Mammaglobin (MG) and Cytokeratin ¨C 19 to provide a rapid diagnosis.The SLN identification was by the combined technique using radiocolloid and patent blue dye. The excised SLNs were sliced in their short axis at intervals of 1.5 mm to 2 mm. The sections were numbered and alternate sections were processed for histopathology and RT-PCR assay.The study was conducted in 2 phases. The first phase was to evaluate the accuracy and feasibility of RT-PCR assay as an intra-operative diagnostic test. The second phase was the real time application of the results to inform decision regarding immediate ALND. Results This prospective study comprised of 166 patients with 164 females and 2 male patients. 86 patients had left breast cancer, 75 patients had right breast cancer and 5 patients had synchronous bilateral breast cancers. A total of 171 SLNB procedures were done and 271 SLNs were excised at an average of 1.58 SLNs per procedure. Only a total of 266 SLNs were included in the analysis as the RT-PCR assay results of 5 SLNs were invalid. All the SLNs underwent RT-PCR assay and the results were compared to the final histology. The results were recorded on per patient and per node basis
%U http://www.sciedu.ca/journal/index.php/jst/article/view/258