'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;306[4]385-393.
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
-
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013
-
If you became brain-dead, would you want them to pull the plug?
May 17, 2013
-
MRI bill question
May 15, 2013
-
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013
-
Alcohol and acetaminophen
May 13, 2013
-
Marie Curie's leukemia
May 13, 2013
- More from Physics Forums - Medical Sciences
More news stories
New smartphone application improves colonoscopy preparation
The use of a smartphone application significantly improves patients' preparation for a colonoscopy, according to new research presented today at Digestive Disease Week (DDW). The preparation process, which begins days in ...
Cancer
22 hours ago |
not rated yet |
0
Research examines new methods for managing digestive health
Research presented at Digestive Disease Week (DDW) explores new methods for managing digestive health through diet and lifestyle.
Cancer
23 hours ago |
not rated yet |
1
New colonoscope provides ground-breaking view of colon
A ground-breaking advance in colonoscopy technology signals the future of colorectal care, according to research presented today at Digestive Disease Week(DDW). Additional research focuses on optimizing the minimal withdrawal ...
Cancer
May 18, 2013 |
5 / 5 (2) |
0
ASCO: combo antibody therapy effective for melanoma
(HealthDay)—Concurrent use of two immune checkpoint antibodies—ipilimumab and nivolumab—may be effective for the treatment of advanced melanoma, according to a proof-of-principal study presented in ...
Cancer
May 17, 2013 |
not rated yet |
0
Risk factors ID'd for poor cutaneous cell CA outcomes
(HealthDay)—The risks of metastasis and death associated with cutaneous squamous cell carcinoma (CSCC) are low, but significant, and risk factors for poor outcome include tumor diameter, invasion beyond ...
Cancer
May 17, 2013 |
not rated yet |
0
|
Researchers identify a potential new risk for sleep apnea: Asthma
Researchers at the University of Wisconsin have identified a potential new risk factor for obstructive sleep apnea: asthma. Using data from the National Institutes of Health (Heart, Lung, and Blood Institute)-funded Wisconsin ...
New theory on genesis of osteoarthritis comes with successful therapy in mice
Scientists at Johns Hopkins have turned their view of osteoarthritis (OA) inside out. Literally. Instead of seeing the painful degenerative disease as a problem primarily of the cartilage that cushions joints, ...
Computational tool translates complex data into simplified 2-dimensional images
In their quest to learn more about the variability of cells between and within tissues, biomedical scientists have devised tools capable of simultaneously measuring dozens of characteristics of individual ...
Study finds that sleep apnea and Alzheimer's are linked
A new study looking at sleep-disordered breathing (SDB) and markers for Alzheimer's disease (AD) risk in cerebrospinal fluid (CSF) and neuroimaging adds to the growing body of research linking the two.
'Gap' for HIV vaccine efforts after latest setback
The hunt for an HIV vaccine has gobbled up $8 billion in the past decade, and the failure of the most recent efficacy trial has delivered yet another setback to 26 years of efforts.
Ginger compounds may be effective in treating asthma symptoms
Gourmands and foodies everywhere have long recognized ginger as a great way to add a little peppery zing to both sweet and savory dishes; now, a study from researchers at Columbia University shows purified components of the ...