'Hidden' cancer cells not a factor in early-stage breast cancer survival rates
A new study shows that removing lymph nodes due to the presence of occult, or microscopic, cancer cells found in the sentinel lymph node the one closest to the tumor -- has no impact on survival outcomes of women with early-stage breast cancer. The principal investigator of the study is Armando E. Giuliano, MD, of Cedars-Sinai, who already is renowned for his clinical expertise and for his seminal research on lymph node removal in women with early-stage breast cancer.
The latest study, conducted by the American College of Surgeons Oncology Group (ACOSOG) and supported by the National Cancer Institute, was published in the July 27 issue of the Journal of the American Medical Association. Giuliano is the executive vice chair of surgery for surgical oncology and holds several leadership positions at Cedars-Sinai's Samuel Oschin Comprehensive Cancer Institute.
His previous findings related to sentinel lymph node biopsy and cancer diagnosis revolutionized the accepted approach to treating early-stage breast cancer. His groundbreaking research, published earlier this year in the Journal of the American Medical Association, challenged the commonly held belief that removing all lymph nodes not just the sentinel nodes closest to the tumors was key to improving survival rates.
The ACOSOG research showed the opposite: Survival outcomes were no different between women undergoing total lymph node removal and those only having the sentinel lymph node removed. This finding dramatically changed the surgical approach for these patients. Women now can be spared the pain and side effects of comprehensive lymph node removal.
In this new study, Giuliano and colleagues sought to determine whether there is an association between patient survival rates and the presence of microscopic cancer cells that have spread from an early-stage tumor to nearby lymph nodes.
Occult metastases usually cannot be seen in routine pathological or clinical examination. The tiny cells were detected with immunochemical staining of sentinel lymph nodes and bone marrow specimens from patients with early-stage breast cancer.
Some 5,210 women with breast cancer enrolled in the American College of Surgeons Oncology Group trial at 126 sites nationwide from May 1999 to May 2003. All subjects underwent breast-conserving surgery and sentinel lymph node dissection.
"This study shows that the presence of tiny sentinel lymph node metastases has no bearing on survival outcomes," said Giuliano, co-director of the Saul and Joyce Brandman Breast Center a Project of the Women's Guild.
According to Giuliano, removing lymph nodes can cause complications such as lymphedema, a chronic and often painful swelling in the arm that can be debilitating. "Treating the patient doesn't end with stopping the cancer," he says. "We want to make sure we maximize the patient's quality of life even after cancer treatment is completed."
More information: JAMA. 2011;306385-393.
Provided by Cedars-Sinai Medical Center
- Poorer breast cancer survival associated with micrometastases in axillary lymph nodes Feb 26, 2010 | not rated yet | 0
- Limited lymph node removal for certain breast cancer does not appear to result in poorer survival Feb 08, 2011 | not rated yet | 0
- Largest-ever breast cancer surgery study published Sep 22, 2010 | not rated yet | 0
- Microbubble ultrasound and breast biopsies Feb 01, 2011 | not rated yet | 0
- Researchers find two biomarkers with potential to predict breast cancer spread Dec 15, 2006 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
May 23, 2013 Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
In recent years, microRNAs (miRNAs) and other non-coding RNAs are small molecules that help control the expression of specific proteins. In recent years they have emerged as disease biomarkers. miRNA profiles have been used ...
Cancer 17 hours ago | not rated yet | 0
Cancer cells spread and grow by avoiding detection and destruction by the immune system. Stimulation of the immune system can help to eliminate cancer cells; however, there are many factors that cause the immune system to ...
Cancer 17 hours ago | 5 / 5 (1) | 0
Researchers from London's Kingston University have begun a two-year study which could help prolong the lives of people with colorectal tumours.
Cancer 21 hours ago | 5 / 5 (1) | 0
Transformative research from Western University has identified new hormones in the body which may suppress breast cancer and stimulate the regression of breast tumors.
Cancer 21 hours ago | 5 / 5 (2) | 0
(Medical Xpress)—Curtin University researchers have found evidence that targeting specific cells in the body can reverse the effects of cancer on the immune system.
Cancer 22 hours ago | 5 / 5 (4) | 0
(Medical Xpress)—A new study by researchers in the US has shown that an ancient virus can be modified to help in the fight against the simian immunodeficiency virus SIV, which is the equivalent in monkeys ...
21 hours ago | 5 / 5 (3) | 0 |
Two mutations central to the development of infantile myofibromatosis (IM)—a disorder characterized by multiple tumors involving the skin, bone, and soft tissue—may provide new therapeutic targets, according to researchers ...
15 hours ago | 3 / 5 (2) | 0 |
Women at a particular stage in their monthly menstrual cycle may be more vulnerable to some of the psychological side-effects associated with stressful experiences, according to a study from UCL.
18 hours ago | 3.7 / 5 (3) | 0 |
Ernie Pyle – an iconic war correspondent in World War II – reportedly said "There are no atheists in foxholes." A new joint study between two brothers at Cornell and Virginia Wesleyan found that only ...
21 hours ago | 2.5 / 5 (4) | 2
How can healthy people who hear voices help schizophrenics? Finding the answer for this is at the centre of research conducted at the University of Bergen.
21 hours ago | 4 / 5 (2) | 2
Biological processes are generally based on events at the molecular and cellular level. To understand what happens in the course of infections, diseases or normal bodily functions, scientists would need to ...
18 hours ago | 5 / 5 (5) | 0 |