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OSNA Total Tumor Load for the Prediction of Axillary Involvement in Breast Cancer Patients: Should We use Different Thresholds According to the Intrinsic Molecular Subtype? MOTTO Study Bernet, L Hardisson, David Rodrigo, M Córdoba, A Sancho, M. Peg, Vicente Institut Català de la Salut [Bernet L] Department of Pathology, Hospital Universitario del Vinalopó, Elche, Spain. [Hardisson D] Department of Pathology, Hospital Universitario La Paz, Madrid. Hospital La Paz Institute for health Research (IdiPAZ), Universidad Autónoma de Madrid. [Rodrigo M] Department of Pathology, Hospital Universitario de Burgos, Burgos, Spain. [Córdoba A] Department of Pathology, Hospital Universitario de Navarra, Navarra, Spain. [Sancho M] Department of Pathology, Hospital Universitario de Salamanca, Salamanca, Spain. [Peg V] Servei d’Anatomia Patològica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Spanish Biomedical Research Network Centre in Oncology (CIBERONC), Madrid, Spain Vall d'Hebron Barcelona Hospital Campus Mama - Càncer Metàstasi limfàtica Marcadors tumorals DISEASES::Neoplasms::Neoplasms by Site::Breast Neoplasms DISEASES::Neoplasms::Neoplastic Processes::Neoplasm Metastasis::Lymphatic Metastasis ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Anthropometry::Body Weights and Measures::Tumor Burden ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias de la mama ENFERMEDADES::neoplasias::procesos neoplásicos::metástasis neoplásica::metástasis linfática TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::antropometría::pesos y medidas corporales::carga tumoral Breast cancer; Molecular subtype; Total tumor load Cáncer de mama; Subtipo molecular; Carga tumoral total Càncer de mama; Subtipus molecular; Càrrega tumoral total Aims: To assess the impact of the molecular subtype (MS) on the total number of CK19 mRNA copies in all positive SLN (TTL) threshold, to predict non-SLN affectation, and to compare 5 years progression-free survival (PFS) according to the risk of recurrence (ROR) group by PAM50. Methods: Cohort with infiltrating breast cancer with intra-operative metastatic SLN detected by one-step nucleic acid amplification (OSNA) assay who underwent subsequent ALND. Logistic regression was used to assess a possible interaction between TTL and MS(Triple Negative, Her-2-Enriched, Luminal A, or Luminal B), or hormone receptors (HR: positive or negative) by immunohistochemistry (IMH). Cox regression was used to compare PFS and OS in the 3 ROR groups (high, medium, or low). Results: TTL was predictive of non-SLN affectation in both univariate (OR [95% CI]: 1.72 [1.43, 2.05], P < .001) and multivariate (1.55 [95% CI: 1.04, 2.32], P = .030) models, but MS-IMH or HR-IMH, and their interactions with TTL were not (best multivariate model: HR + main effect OR 1.16 [95% CI: 0.18, 7.64], P = .874; interaction OR: 1.04 [0.7, 1.55], P = .835; univariate model: HR + main effect OR: 1.44 [95% CI: 0.85, 2.44], P = .180). PFS was lower in the high-risk ROR group (81.1%) than in the low-risk group (93.9%) (HR: 3.68 [95 CI: 1.70, 7.94], P < .001). Conclusions: our results do not provide evidence to support the utilization of subtype-specific thresholds for TTL values to make therapeutic decisions on the axilla. The ROR group was predictive of 5 years-PFS. This study was funded by Sysmex España, S.L. 2023-08-30T11:37:54Z 2023-08-30T11:37:54Z 2023-07-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Bernet L, Hardisson D, Rodrigo M, Córdoba A, Sancho M, Peg V, et al. OSNA Total Tumor Load for the Prediction of Axillary Involvement in Breast Cancer Patients: Should We use Different Thresholds According to the Intrinsic Molecular Subtype? MOTTO Study. Clin Pathol. 2023 Jul 31;16:1-8. 2632-010X https://hdl.handle.net/11351/10185 10.1177/2632010X231183693 37534372 001040565200001 http://hdl.handle.net/11351/10185 eng Clinical Pathology;16 https://doi.org/10.1177/2632010X231183693 Attribution-NonCommercial 4.0 International http://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess application/pdf SAGE Publications Scientia