Letters Intraoperative assessment of axillary lymph nodes in breast cancer

In defence of one step nucleic acid amplification for intraoperative assessment of axillary lymph nodes in breast cancer

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h716 (Published 11 February 2015) Cite this as: BMJ 2015;350:h716
  1. Zenon Rayter, consultant surgeon1
  1. 1Bristol Breast Care Centre, Southmead Hospital, Bristol BS10 5NB, UK
  1. zenon.rayter{at}nbt.nhs.uk

Dixon and colleagues made several damning comments about one step nucleic acid amplification (OSNA), which is used intraoperatively to assess whether sentinel lymph nodes contain metastases.1 These are based on one seriously flawed meta-analysis.2

Firstly, it stated that many published papers on OSNA were financed by the manufacturer (Sysmex, Japan), which is untrue.

Secondly, it quoted a positive predictive value of OSNA for axillary lymph node metastasis of only 0.79 when it should have been 0.86 on the basis of the data presented in …

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