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By Ryan Perkins, M.D.


Analyzing Cancer-Free Lymph Nodes May Help Identify Risk of Breast Cancer Spread

British researchers have developed a way to more fully analyze cancer-free lymph nodes to identify breast cancer patients at high risk for metastases.

Lymph nodes are small clusters of immune cells that function as a filter for the immune system. Since the lymph nodes located under the arm – axillary lymph nodes – are typically the first point breast cancer travels, evaluation of these nodes is particularly important. When cancer is found to have spread to the lymph nodes, a more aggressive treatment course is recommended.

In the study published in The Journal of Pathology: Clinical Research, scientists analyzed both positive (presence of cancer cells) and negative (cancer-free) lymph nodes and discovered features in the cancer-free nodes that were valuable in predicting the risk of cancer spread.

Using sophisticated mathematical models to analyze morphological changes of the lymph nodes, researchers were able to develop a score to predict the patient’s risk of breast cancer spread. There were 143 patients with cancer cells in the lymph nodes. Using current guidelines, these patients were considered at high risk for metastases to distant organs.

However, when researchers analyzed variances in the structure of the cancer-free nodes, they were able to differentiate between individuals who were more, or less, likely to develop secondary cancers. They determined approximately one-quarter of the high-risk group was unlikely to develop metastatic disease within ten years.

Although larger studies are needed to validate these results, I believe this study puts us one step closer to identifying breast cancer patients truly at high-risk for metastases. This would allow patients that fall into the high-risk category to be treated more aggressively, while sparing additional treatment for low-risk breast cancer patients.

By developing identifying markers to predict the risk of metastases rather than waiting for cancer to spread before initiating treatment, it is my belief we can increase survival and achieve the best possible outcomes for all breast cancer patients.

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