Table 1.
Clinico-pathological characteristics of the 647 invasive breast carcinomas.
Figure 1.
Correlation between OSNA assay and histology results in the entire series of 903 SLNs. Panel A:
The histograms summarize the percentage of concordant and discordant results on SLNs analyzed by OSNA and histology. Panel B: Representative examples of CK19 immunostaining (immunoperoxidase) of a micrometastasis (a) and a macrometastasis (b) in two different SLNs compared to the matched OSNA curves (a-b) (scale bar = 90 µm). Panel C: The histograms show the distribution of −/negative, +/micrometastatic and ++/macrometastatic SLNs analyzed both by molecular and morphological methods. The percentage of micrometastases by OSNA was 11.9% and by histology 7.4%, whereas the percentage of macrometastases by OSNA was 10.4% and by histology 13.4%. Histology included H&E staining and IHC. OSNA−: <250; OSNA+ : >250≤5000; OSNA++: >5000 CK19 mRNA copies/µl.
Figure 2.
Relationship between number of SLNs tested by OSNA and ALND status.
The percentage of negative ALND was significantly higher in patients with 1 OSNA positive SLN (65.8% vs 34.2%). Conversely, the percentage of positive ALND was significantly higher in patients with 2 or more OSNA positive SLNs (66.7% vs 33.3%) (p = 0.004).
Table 2.
Relationship between axillary non-sentinel lymph node status and number of SLNs analyzed.
Figure 3.
Relationship between SLN status and bio-pathological parameters.
The histograms show that OSNA positive results are significantly correlated with (Panel A) poor differentiated tumor (p = 0.039), (Panel B) high proliferation index (p = 0.028) and (Panel C) presence of lymphovascular invasion (LVI p<0.0001).
Figure 4.
MCA of the 179 OSNA +/++ BC patients stratified by molecular subtypes and relationship between BC subtypes and ALND status in the subset of 91 OSNA+ BC patients.
Panel A: The MCA graph demonstrates that ALND (+) is located in the quadrant containing the most aggressive phenotypes (T2 tumors, positive LVI, HER2 subtype, OSNA++) in contrast to ALND (−) which is associated to more favourable bio-pathological parameters (T1 tumors, absence of LVI, LA subtype). *LA: Luminal A; LB: Luminal B; HS: HER2 subtype; TN: Triple Negative Panel B : The histograms report the distribution of molecular subtypes in the 72 OSNA+ cases with ALND negative and CK19 mRNA <2000 copies/µl (range 270–1900). Panel C : The histograms report the distribution of molecular subtypes in the 19 OSNA+ cases with ALND positive and CK19 mRNA >2000 copies/µl (range 2100–4600).
Table 3.
Logistic regression analysis of negative factors predictive of ALND involvement.
Table 4.
Analysis of the 42 discordant cases between OSNA and histology.