Clinical significance of micrometastases in axillary lymph nodes assessed by reverse transcription-polymerase chain reaction in breast cancer patients.

Abstract	We evaluated the clinical significance of micrometastases in axillary lymph nodes (AxLNs) of breast cancer patients for prediction of prognosis. Archived formalin-fixed paraffin-embedded AxLN specimens from 129 node-negative breast cancer patients diagnosed by routine H&E staining between 1986 and 1990 were subjected to carcinoembryonic antigen-specific reverse transcription-PCR analysis. Micrometastases were detected in 40 of 129 (31.0%) node-negative breast cancer patients. After a median follow-up period of 105.6 months, log-rank test analysis indicated that 10-year disease-free and overall survival rates by Kaplan-Meier methods were significantly better in patients without micrometastases than in patients with micrometastases [disease-free survival, 87.6% versus 66.1% (P = 0.0008); overall survival, 93.7% versus 67.8% (P = 0.0024)]. The presence of micrometastases in AxLNs was revealed by multivariate analyses to be an independent and significant predictor of clinical outcome. The hazard ratio was 3.992 (95% confidence interval, 1.293-12.323; P = 0.0161) for relapse and 4.293 (95% confidence interval, 1.043-17.675; P = 0.0436) for cancer-related death. The molecular staging of AxLNs using reverse transcription-PCR is useful for prediction of clinical outcome in early-stage breast cancer patients and can provide a powerful and sensitive complement to routine histopathological analysis.
Authors	N Masuda, Y Tamaki, I Sakita, M Ooka, T Ohnishi, M Kadota, N Aritake, K Okubo, M Monden
Journal	Clinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 6 Issue 11 Pg. 4176-85 (Nov 2000) ISSN: 1078-0432 [Print] United States
PMID	11106229 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References	Carcinoembryonic Antigen RNA, Messenger
Topics	Adult Aged Aged, 80 and over Breast Neoplasms (mortality, pathology) Carcinoembryonic Antigen (genetics) Female Humans Lymphatic Metastasis Middle Aged Prognosis RNA, Messenger (analysis) Reverse Transcriptase Polymerase Chain Reaction Survival Rate

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