Molecular Analysis of Sentinel Lymph Nodes in Patients With Breast Cancer Using One-Step Nucleic Acid Amplification (OSNA): Does Its High Sensitivity Lead to Axillary Overtreatment?

Abstract

Background: OSNA is a molecular technique for sentinel lymph node (SN) analysis in breast cancer that can be performed intraoperatively, enabling a completion axillary lymph node dissection during the same operative procedure. Compared to standard histology, OSNA may yield more (micro)metastases and result in more axillary lymph node dissections or radiotherapy. We investigated whether axillary treatments increase when using OSNA, applying current Dutch guidelines, based on a multidisciplinary approach with axillary lymph node dissection only being performed in patients at high risk for N2-disease, when more than two macrometastases are present in the sentinel node.