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On a long-term basis, the study found that the presence of occult cancer metastases in the axillary lymph nodes detected by the antibody technique identified women with a greater chance of developing overt metastases and dying of breast cancer. This effect was strongest in older (post-menopausal) women, the group with the highest incidence of breast cancer. However, in younger (pre-menopausal) women with breast cancer, the presence of occult lymph node metastases did not appear to have a significant effect on overt metastases or survival.

Scientists said the findings indicate cancers may spread differently in older women. Further study is needed to understand the differences in breast cancer spread and behavior between older women and younger women.

The study findings point to better ways to treat each cancer patient individually, Cote said, based on the specific characteristics of their cancer. Finding occult metastases in the lymph nodes would be one factor. Cote and colleagues also have found that occult metastases can be detected in the bone marrow of patients who otherwise have no evidence of metastases by conventional methods. Combined with other information, such as age, the presence of hormone receptors in a cancer cell, and the status of other genes and proteins known to be important in breast cancer treatment such as HER2/neu proteins, therapies can be tailored to fit the needs of each individual patient. Currently, a general recipe of surgery, radiation and chemotherapy is considered for everyone with early stage breast cancer.

"Once you get this information, you get a better idea of the nature of the tumor," Cote said. "The ability to identify those patients who need treatment, and the specific type of treatment that would most benefit the patient, would certainly represent a major advance in the management of breast cancer."

Additionally, some women who ordinarily would receive c
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Contact: Alicia Di Rado
dirado@hsc.usc.edu
323 442 2830
University of Southern California
10-Sep-1999