Are breast cancer axillary node micrometastases worth detecting?

Article Abstract:

Approximately 25 to 30 percent of breast cancer patients do not, initially, show any axillary node involvement on the same side as the primary breast tumor. The initial presence of more distant metastases is also not immediately identifiable. These patients will frequently relapse within the first five years after surgery. Adjuvant chemotherapy, administered at the initial intervention, has been shown to be beneficial to those who have additional involved nodes. For those treated without additional metastatic lesions, the chemotherapy causes significant adverse side effects. Alternative and more advanced staining and immunological techniques applied to specimens of presumed ''node-negative'' cases yielded an additional 20 percent of positive identifications. In a review of more than 2,400 negative nodes in a collection of studies, an additional 13 percent were positive. In the International Breast Cancer Trial (V), 10 percent of the 1,000 specimens reviewed converted to positive. These results indicate the advantage of going beyond the routine examination of axillary nodes. There is also need for other factors to be examined, such as tumor size, type and grade, to identify the cases of possible conversion to positive. Other features that may be of value in identifying node-negative disease are cathepsin-D production, and epithelial growth factor receptor or proto-oncogene expression. The most valuable alternative may ultimately be the polymerase chain reaction with a breast cell specific probe. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cancer metastasis, editorial

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Humbug breast cancer follies: odds ratios for the relative risk of truth; unsolicited reportage from a board certified non-epidemiologist

Article Abstract:

Current reports on the epidemiology of breast cancer are not entirely accurate and demean women by frightening them through the padded figures of the reports. Mammography, hailed as the saving grace from breast cancer, also produces little actual benefit than what is advertised. Women are entitled to be served with honest, straight facts about the risk of breast cancer, the reliability, true value and downside of diagnostic procedures and the lifestyle qualities and mode of outcome measurement of treatment alternatives.

Evaluation, Mammography

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Many don't want to know if they have breast-cancer gene

Article Abstract:

Only about 50% of individuals with a family history of ovarian or breast cancer are likely to request genetic testing, according to a study conducted by doctors at the Lombardi Cancer Center at Georgetown University Medical Center. Socio-economic status and the number of relatives affected with breast and/or ovarian cancer are directly related to patient requests for genetic susceptibility testing.

Surveys, Ovarian cancer, Genetic screening, Genetic testing

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