Lymph Node Cancer Spread Might be Predicted by Routine Breast Cancer Biopsy

by Rajshri on  April 19, 2010 at 6:07 PM Cancer News
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 Lymph Node Cancer Spread Might be Predicted by Routine Breast Cancer Biopsy
Researchers say that predicting breast cancer spread from a sentinel lymph node removed during surgery is a hit or miss affair.

There are still many false negatives, which means the node, when analyzed under a microscope, appears clean of cancer cells, but metastasis can still occur in the patient. The sentinel node is the first lymph node in the axilla that cancer spreads to.

Now, researchers from Georgetown Lombardi Comprehensive Center say that they have clues to molecular markers on breast tumors that may predict which cancers will metastasize to the lymph node system. Details of the study will be presented at the AACR 101st Annual Meeting 2010.

In a pilot study comparing genomic alterations in both breast cancer cells and sentinel lymph nodes removed from 15 patients whose cancer spread to the lymph nodes, researchers found genes that were altered (amplified or deleted) in both samples. These alterations affected genes that function as either oncogenes or tumor suppressors. The final goal is to be able to identify, at the time of the diagnosis, when a patient has a routine biopsy of their tumor, who is at higher risk for development of lymph node metastasis, says Luciane Cavalli, PhD, an assistant professor of oncology at Lombardi.

"To our knowledge, very few studies have looked specifically for genomic alterations in sentinel nodes in comparison to the primary tumor from the same patient. If we find markers that can be significantly associated with patients that develop axillary metastasis, we can check for these markers at an early stage of the cancer management, before axillary lymph node metastasis develops" says Cavalli. "That will give physicians a chance to treat what is otherwise an unseen metastasis."

Currently, a sentinel lymph node is removed when a patient undergoes surgery to remove breast tumors, and the node is examined for evidence of cancer cells while the operation is in progress. If these malignant cells are seen, additional nodes in the axilla are removed, Cavalli says. "This procedure is performed during the surgery, and the methods currently used to look for tumor cells in these nodes are not ultra sensitive, and may therefore miss these malignant cells especially in the case of micrometastasis."

Cavalli and her team first screened the genomes of cells from both tumors and nodes from the same patient using comparative genome hybridization (CGH), and found that most of the genomic regions affected were similar in both of the samples. . They then used microarray technology (array-CGH) to identify the genes altered in these regions and found several that were altered in patient lymph nodes and tumors. Some of these genes are well known, such as the growth promoting gene her2neu, and the tumor suppressor BRCA1.

"It differed between patients - in some, BRCA1 was missing in both samples, in others, Her2neu or other genes were amplified," Cavalli said. The researchers are now validating their results in other patient samples. "If we can use these genomic markers to identify tumor cells in the sentinel lymph node to reduce the false negative rates that now exist in sentinel node biopsy, we can advance one step forward in patient care," Cavalli says.

Source: Eurekalert

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To the people that don't think these "pink promotions" are doing any good for breast cancer: I agree with you that breast cancer is being employed as a cheap means of gaining sympathy and is used by most companies as nothing more than a marketing strategy for their other crap products [a lot like selling promotional items at a loss, except most places are actually making profits off of these "charity" promotions]. I used to denounce these companies, too, but the reality is that most people have no interest/desire to care about breast cancer research unless they or someone close to them has suffered from it. I could probably be guilty of the same thing the only reason I even found this page is because I was searching for info about complications I had from a removal of a malignant node (you can see for yourself what happened bad breast reconstruction pics, but make sure you didn't just eat). As shady as these companies are, with most giving maybe a penny to actual breast cancer research off of every pink nic nac they sell, the reality is that their "contribution," as disingenuous as it is, is better than nothing at all. If it wasn't for greedy, shady corporations trying to exploit ppl's emotions, I don't see any other way that we can raise awareness and garner support for this cause. And let's face it, interest groups don't work when the only money coming in is from the small group of ppl that are actually motivated enough to join. People just simply don't care unless it's affecting them directly.


I underwent breast augmentation after I had a sentinel node removed, and I have to warn you that sometimes it’s better to pay a little bit more and go to a more reputable doctor. I’m not going to list his name because it’s not like a got an infection or was a victim of malpractice or anything – it’s just that he has a poor eye for his work, to put it mildly. If you really want to see what I mean [and have the constitution for this sort of thing] look at the breast augmentation before and after pictures. I understand that I am still recovering from the removal of the lymph node, but this is obviously a botched job here. I guess that’s what I get for getting the operation in Chula Vista.


I understand that an ounce of prevention is worth a ton of cure, but the thing is that no one knows for sure just how far out we are from finding a cure. In the mean time though, I think it's more important to focus on the tasks at hand - for instance, methods of treatment for those who already have it. Having survived breast cancer myself, I found it a little frustrating that there was this relatively huge amount of support for breast cancer research, and little for those who are currently suffering. It's not that I don't appreciate all these donation commercials and pink ribbon stickers for your car and what not, but those do nothing for the ones like me, who have already undergone treatment, and are now focusing on breast reconstruction and getting their lives back.

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