Correlation between molecular metastases in sentinel lymph nodes of breast cancer patients and St Gallen risk category

Eur J Surg Oncol. 2007 Feb;33(1):16-22. doi: 10.1016/j.ejso.2006.09.013. Epub 2006 Oct 27.


Aims: To evaluate the clinical significance of tumour metastases detected using real-time reverse transcription-PCR (RT-PCR) in sentinel lymph nodes (SLN) of breast cancer patients.

Methods: Sixty-seven patients with T1-T2 primary breast cancer were included in a prospective study. SLN were analysed for the presence of metastatic tumour cells using standard histopathology staining, immunochemistry (IHC) and multimarker real-time RT-PCR assay for mammaglobin (MMG), carcinoembryonic antigen (CEA) and cytokeratin-19 (CK19) mRNA expression. Correlations between molecular metastases and traditional clinicopathological prognostic factors, including St Gallen risk categories were studied.

Results: Of the 67 patients, 15 (22.3%) had one or more pathology-positive SLN. Five (9.6%) pathology-negative SLN were positive by IHC and 19 (36.5%) by RT-PCR. Of note, RT-PCR analysis was also positive in all cases with pathology- or IHC-positive SLN. MMG was the most informative tumour marker in the panel. Molecularly detected metastases were significantly associated with intermediate St Gallen risk category (p=0.023).

Conclusion: Molecular staging of SLN using real-time RT-PCR for early breast cancer could serve as a useful complement to standard clinicopathological risk factors. Studies with long-term follow-up are necessary to define the impact of molecular metastases on disease free survival and overall survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / genetics
  • Biomarkers, Tumor / metabolism
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / pathology
  • Carcinoembryonic Antigen / genetics*
  • Carcinoembryonic Antigen / metabolism
  • Carcinoma, Ductal, Breast / genetics*
  • Carcinoma, Ductal, Breast / metabolism
  • Carcinoma, Ductal, Breast / secondary
  • Female
  • Follow-Up Studies
  • Gene Expression Regulation, Neoplastic*
  • Humans
  • Immunohistochemistry
  • Keratin-19 / genetics*
  • Keratin-19 / metabolism
  • Lymphatic Metastasis
  • Mammaglobin A
  • Middle Aged
  • Neoplasm Proteins / genetics*
  • Neoplasm Proteins / metabolism
  • Neoplasm Staging
  • Prognosis
  • Prospective Studies
  • RNA, Neoplasm / genetics*
  • Reverse Transcriptase Polymerase Chain Reaction
  • Risk Factors
  • Sentinel Lymph Node Biopsy
  • Uteroglobin / genetics*
  • Uteroglobin / metabolism


  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • Keratin-19
  • Mammaglobin A
  • Neoplasm Proteins
  • RNA, Neoplasm
  • SCGB2A2 protein, human
  • Uteroglobin