'Micro' Spreading of Breast Cancer Needs Treating, Study Urges
June 2 -- MONDAY, June 1 (HealthDay News) -- Researchers are now recommending that doctors treat women with breast cancer who have tiny metastases in the so-called sentinel lymph nodes.
That's because leaving these cancers untreated appears to result in a higher rate of cancer recurrence, according to a new study.
Skipping additional treatment for the tiny metastases, known as micrometastases or micromets, could actually result in more deaths, said the study's lead author, Dr. Vivianne Tjan-Heijnen, a professor of medical oncology at Maastricht University Medical Center in the Netherlands.
She presented the findings Monday at a press briefing at the annual meeting of the American Society of Clinical Oncology in Orlando, Fla.
About 10 percent of doctors are not following up with these micromets, the study also found.
On the flip side, another study being presented at the meeting found that too many CT screening tests for lung cancer are being performed, resulting in an inordinately high number of false-positives, with no clear benefits for patients.
For the breast cancer study, Tjan-Heijnen explained that the sentinel lymph node is important in detecting the spread of cancer because it "is the first on which the breast [and thus breast cancer] drains."
"If it's negative, no further treatment is required," she said. "But to prevent false-negative results, it is important that the sentinel node is intensively examined. This has led to an increased detection of isolated tumor cells and micrometastases."
The big question was whether these cells end up causing problems down the line.
Apparently they can, the study found. Over five years, cancer appeared in additional lymph nodes at a rate 4.5 times higher in women who did not receive additional treatment than in those who had surgery or radiation.
The new study "doesn't change the standard of care for node-positive disease, even when there is microscopic disease," noted Dr. Rick Bleicher, a breast surgeon at Fox Chase Cancer Center in Philadelphia. "It reinforces the standard of care, which is axillary dissection," meaning the removal of affected nodes nearest the breast, he said.
