Impact of analysis of the sentinel lymph node by one-step nucleic acid amplification (OSNA) compared to conventional histopathology on axillary and systemic treatment: data from the Dutch nationwide cohort of breast cancer patients

• DOI: 10.1007/s10549-023-07065-0
• Publication Date: 2023-07-27T02:01:16Z
• Authors: Elisabeth R. M. v...; Ingrid G. M. Poodt; Merel A. Spiekerm...; James van Bastelaar; Alfred Janssen; Bart de Vries; Marc B. I. Lobbes; Lee H. Bouwman; Yvonne L. J. Vissers
• Keywords: Micrometastasis; Histopathology; Histology; Axillary lymph nodes; Axilla

Abstract Purpose The outcome of the sentinel lymph node in breast cancer patients affects adjuvant treatment. Compared to conventional histopathology, analysis by one-step nucleic acid amplification (OSNA) harvests more micrometastasis, potentially inducing overtreatment. In this study we investigated impact OSNA on treatment, compared histopathological analysis. Methods Data from T1–3 with nodes analysed between January 2016 and December 2019 (OSNA group, n = 1086) Zuyderland Medical Centre, Netherlands, were concurrent data Netherlands Cancer Registry (NKR) where examined histology (histology 35,143). Primary outcomes micro- or macrometastasis, axillary treatments (axillary dissection (ALND) radiotherapy (ART)), chemotherapy, endocrine therapy. Statistics Pearson Chi-square. Results group micrometastasis (14.9%) detected (7.9%, p < 0.001). No difference treatment groups was (14.3 vs. 14.4%). case mastectomy ALND preferred over ART (4.4%, cases no seen. There administration chemotherapy groups. Endocrine administrated less often (45.8% 50.8%, 0.002). Conclusion More but subsequent increase systematic noticed. When performing OSNA, there a preference for ART.