Breast Cancer Cells Fayetteville NC

Breast cancer patients with isolated tumor cells or tiny "micrometastases" in the lymph nodes benefit from adjuvant treatment, such as post-surgical chemotherapy or hormonal therapy, a new study finds.

Shirish Devasthali, MD
(910) 483-8586
PO Box 53095
Fayetteville, NC
Specialties
Oncology (Cancer), Internal Medicine
Gender
Male
Languages
Hindi, Other, Russian
Education
Medical School: First Moscow Sechenov Med Inst, Moscow, Russia
Graduation Year: 1980
Hospital
Hospital: Cape Fear Valley Med Center, Fayetteville, Nc
Group Practice: Blood & Cancer Clinic

Data Provided by:
Sajjad A Malick, MD
(910) 609-6910
PO Box 42935
Fayetteville, NC
Specialties
Oncology (Cancer), Internal Medicine
Gender
Male
Education
Medical School: Dow Med Coll, Univ Of Karachi, Karachi, Pakistan
Graduation Year: 1988
Hospital
Hospital: Cape Fear Valley Med Center, Fayetteville, Nc; Betsy Johnson Mem Hosp, Dunn, Nc
Group Practice: Hematology Oncology Assoc

Data Provided by:
Tariq Nazir, MD
(910) 483-8586
PO Box 53095
Fayetteville, NC
Specialties
Internal Medicine, Hematology-Oncology
Gender
Male
Education
Medical School: Sind Med Coll, Univ Of Karachi, Karachi,
Graduation Year: 1990

Data Provided by:
Surajit Chaudhuri
(910) 483-8361
1205 Cape Ct
Fayetteville, NC
Specialty
Hematology / Oncology

Data Provided by:
Arleen Kaye Thom, MD
(910) 678-0652
3314 Melrose Rd
Fayetteville, NC
Gender
Female
Education
Medical School: Johns Hopkins Univ Sch Of Med, Baltimore Md 21205
Graduation Year: 1983
Hospital
Hospital: Cape Fear Valley Med Center, Fayetteville, Nc; Highsmith-Rainey Memorial Hosp, Fayetteville, Nc

Data Provided by:
Herman Allen Godwin, MD
(919) 323-1152
1813 Lakeshore Dr
Fayetteville, NC
Specialties
Oncology (Cancer)
Gender
Male
Education
Medical School: Bowman Gray Sch Of Med Of Wake Forest Univ, Winston-Salem Nc 27157
Graduation Year: 1963

Data Provided by:
Christina Lee Wells, MD
(910) 484-4615
1133 Offshore Dr
Fayetteville, NC
Specialties
Oncology (Cancer)
Gender
Female
Education
Medical School: Univ Of Va Sch Of Med, Charlottesville Va 22908
Graduation Year: 1992

Data Provided by:
John Hugh Bryan, MD
(910) 609-6690
PO Box 41208
Fayetteville, NC
Specialties
Oncology (Cancer), Radiation Oncology, Pediatrics
Gender
Male
Education
Medical School: Univ Of Nc At Chapel Hill Sch Of Med, Chapel Hill Nc 27599
Graduation Year: 1969
Hospital
Hospital: Cape Fear Valley Med Center, Fayetteville, Nc; Southeastern Reg Med Ctr, Lumberton, Nc
Group Practice: South East Radiation Oncology

Data Provided by:
Mashour Yousef Yousef, MD
(910) 483-8586
2125 Valleygate Dr Ste 101
Fayetteville, NC
Specialties
Oncology (Cancer)
Gender
Male
Education
Medical School: Univ Of Tichreen, Fac Of Med, Lattakia, Syria (Univ Latakia)
Graduation Year: 1989
Hospital
Hospital: Cape Fear Valley Med Center, Fayetteville, Nc
Group Practice: Blood & Cancer Clinic

Data Provided by:
Zhong Yu
(910) 609-5610
1638 Owen Dr
Fayetteville, NC
Specialty
Internal Medicine, Hematology / Oncology

Data Provided by:
Data Provided by:

Breast Cancer Cells

Provided By:

Breast cancer patients with isolated tumor cells or tiny "micrometastases" in the lymph nodes benefit from adjuvant treatment, such as post-surgical chemotherapy or hormonal therapy, a new study finds.

Until now, many doctors doubted that the presence of micrometastases or isolated tumor cells affected long-term recovery, said Dr. Vivianne Tjan-Heijnen, head of the division of medical oncology at Maastricht University Medical Center in the Netherlands, the lead author of the study.

So these patients often are not offered adjuvant therapy after they undergo breast cancer surgery. But the results of her team's study, published in the Aug. 13 issue of the New England Journal of Medicine, suggest they should be.

Micrometastases, which are too small to be seen on standard screening or diagnostic tests, range from 0.2 to 2.0 millimeters in size. Isolated tumor cells or tumor cell groups are even tinier, less than 0.2 millimeters, said Tjan-Heijnen.

To assess the value of additional treatments of chemo or other adjuvant methods, Tjan-Heijnen and her colleagues followed 2,707 women treated surgically for early-stage breast cancer. They were divided into three groups. The first group included 856 women diagnosed with breast cancer whose sentinel node -- the first node the breast tissue drains into -- was negative and cancer-cell free, who didn't get additional treatment. The second group included 856 women diagnosed with breast cancer with cancer cells found in the nodes, but who didn't get additional treatment. The third group included 995 patients with cancer cells found in the nodes who did get additional treatment.

The additional treatment included chemotherapy (such as taxanes), endocrine therapy (such as tamoxifen or aromatase inhibitors), or systemic therapy (both chemo and endocrine).

The researchers followed the women for a median of 5.1 years (half followed longer, and half for less time) to see if the extra therapy reduced cancer recurrence and increased disease-free survival. They associated the tiny metastases and isolated tumor cells with an absolute decline in five-year disease-free survival of 10 percent. In other words, those with the tiny cancer cells present who are treated with additional therapy had a nearly 10 percent improvement in disease-free survival at five years, they found.

"So, five years after the diagnosis of every 100 patients with micrometastases or isolated tumor cells, 10 more will have a disease event compared with 100 patients with comparable primary tumor characteristics who did not have metastases in the axillary nodes," Tjan-Heijnen said.

The study proves that the micrometastases and the isolated tumor cells are important considerations when evaluating the prognosis, she said.

Cancer specialists have debated how to treat a patient with these small metastases and isolated tumor cells, said Dr. Minetta Liu, director of translational breast cancer research at the Georgetown University Lombardi Comprehensive Cancer Center in Washington, D.C.

The study results suggest that "looking for these cells may be another tool to determine how likely a recurrence is," she said. But more study is needed to validate the findings, she added.

Dr. Hannah Linden, a medical oncologist and associate professor of medicine at the University of Washington School of Medicine in Seattle, said the study results could change current practice. "If these findings are true, they will influence decision making significantly, and help us know which patients really 'need' chemo to give them an advantage in reducing the risk that the tumor recurs," she said.

More information

To learn more about adjuvant therapy for breast cancer, visit the U.S. National Cancer Institute.

SOURCES: Vivianne Tjan-Heijnen, M.D., Ph.D., head of medical oncology division, Maastricht University Medical Center, the Netherlands; Minetta Liu, director of translational breast cancer research, Georgetown University Lombardi Comprehensive Cancer Center, Washington, D.C.; Hannah Linden, M.D., medical oncologist and associate professor of medicine, University of Washington School of Medicine, and joint associate member, Fred Hutchinson Cancer Research Center, Seattle; Aug. 13, 2009, The New England Journal of Medicine

Author: By Kathleen Doheny
HealthDay Reporter

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Read Article at HealthDay.com