Breast Cancer Cells Wilmington 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.

Andrew Philip Brown, MD
(910) 763-1137
2800 Ashton Dr
Wilmington, NC
Specialties
Oncology (Cancer), Radiation Oncology
Gender
Male
Education
Medical School: Univ Of London, Royal Free Hosp Sch Med (See 917-34)
Graduation Year: 1978

Data Provided by:
Peter Ungaro, MD
(910) 342-3001
109 Darley Ln
Wilmington, NC
Specialties
Oncology (Cancer)
Gender
Male
Education
Graduation Year: 2007

Data Provided by:
William Mc Nulty, MD
(910) 763-5182
1515 Doctors Cir
Wilmington, NC
Specialties
Oncology (Cancer)
Gender
Male
Education
Medical School: Univ Of Sc Sch Of Med, Columbia Sc 29208
Graduation Year: 1982

Data Provided by:
Peter C Mancusi-Ungaro
(910) 343-7597
2131 S 17th St
Wilmington, NC
Specialty
Hematology / Oncology

Data Provided by:
John William Anagnost, MD
(910) 343-0447
1515 Doctors Cir
Wilmington, NC
Specialties
Oncology (Cancer), Hematology-Internal Medicine
Gender
Male
Education
Medical School: Jefferson Med Coll-Thos Jefferson Univ, Philadelphia Pa 19107
Graduation Year: 1978
Hospital
Hospital: New Hanover Reg Med Ctr, Wilmington, Nc; Cape Fear Mem Hosp, Wilmington, Nc
Group Practice: Hanover Medical Specialists

Data Provided by:
Arvil D Stephen, MD
(910) 772-7573
3151 S 17th St
Wilmington, NC
Specialties
Oncology (Cancer)
Gender
Male
Education
Graduation Year: 2007

Data Provided by:
Elizabeth Harrer Yoffe, MD
7221 Gray Gables
Wilmington, NC
Specialties
Oncology (Cancer)
Gender
Female
Education
Medical School: Univ Of Fl Coll Of Med, Gainesville Fl 32610
Graduation Year: 1977

Data Provided by:
William McNulty, MD
(919) 763-5182
1515 Doctors Cir
Wilmington, NC
Specialties
Oncology (Cancer)
Gender
Male
Education
Medical School: Univ Of Sc Sch Of Med, Columbia Sc 29208
Graduation Year: 1982

Data Provided by:
Brenda Ann Carroll, MD
(919) 341-3300
1202 Medical Center Dr
Cape Fear, NC
Specialties
Oncology (Cancer)
Gender
Female
Education
Medical School: Med Univ Of Sc Coll Of Med, Charleston Sc 29425
Graduation Year: 1989

Data Provided by:
Martin Benj Meyerson, MD
(910) 251-1839
1988 S 16th St
Wilmington, NC
Specialties
Oncology (Cancer), Radiation Oncology
Gender
Male
Education
Medical School: Univ Of Il Coll Of Med, Chicago Il 60680
Graduation Year: 1968
Hospital
Hospital: New Hanover Reg Med Ctr, Wilmington, Nc
Group Practice: New Hanover Radiation 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