Metastatic breast cancer: length and quality of life

Article Abstract:

Metastatic breast cancer is incurable. When breast cancer cells have colonized other organs of the body and begun developing into secondary tumors, the only course of treatment is the palliation of symptoms. Some patients respond to hormonal treatment, and this is particularly useful since hormonal therapy does not cause many of the grave side effects of conventional chemotherapy. However, in all cases, the cancer will eventually become unresponsive, and more aggressive therapy will be needed. In the November 7, 1991 issue of The New England Journal of Medicine, researchers report that continued chemotherapeutic treatment of patients with advanced breast cancer results in a longer period of freedom from symptoms, but does not improve survival, compared with interrupted treatment. In the latter case, patients are treated and observed for signs of disease progression, at which time they may receive further chemotherapy. This is important information for the practicing oncologist, who may advise women responding well to chemotherapeutic treatment that continued treatment is likely to extend the period of improved quality of life. The results also indicate that women who are experiencing the more severe side effects of chemotherapy may be advised that the discontinuation of treatment will not affect their survival. The observations made in this study raise some other basic scientific questions, however. In animal studies, chemotherapeutic treatment that induces a remission almost invariably lengthens survival. The principle seems simple. If the majority of cancer cells are destroyed, the remaining few take longer to grow to extent that will kill the animal. Among human patients, however, the destruction of the majority of cancer cells often does not lengthen survival. Why this should be is not understood. One possibility is that the cancer cells remaining after chemotherapy actually grow more rapidly than they did before treatment. If this is the case, identifying the factors that alter the rates of growth of cancer cells might result in the development of improved techniques of therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Development and progression, Quality of life, Metastasis

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Approaches to breast-cancer staging

Article Abstract:

Doctors should examine bone marrow biopsies in addition to lymph node biopsies when determining the prognosis of a woman with breast cancer. A study found that an immunocytochemical stain could be used on bone marrow biopsy samples to detect cells that had spread to the bone marrow. Many women had cancer cells in their bone marrow but not in their lymph nodes. However, many women with cancer cells in their bone marrow may still have an excellent prognosis. Women with no cancer cells in their lymph nodes or bone marrow have the best prognosis and may not require aggressive treatment.

Analysis, Tumor staging, Cancer staging

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The sentinal node in breast cancer: a multicenter validation study

Article Abstract:

Biopsy of sentinel lymph nodes may indicate tumor spread in breast cancer less invasively than biopsy of nodes in the armpit. Sentinel lymph nodes are the first lymph nodes to receive lymph drainage from the region of the breast tumor. Researchers injected a radioactive tracer around the tumors in 443 women with breast cancer. Scanning for regions of concentrated tracer identified sentinel nodes in 93% of women, and biopsy of these nodes was identical to armpit-node biopsy results in 97% of cases. The procedure is difficult to perform, so better techniques may be required.

Diagnosis, Lymph nodes, Breast, Needle biopsy, Lymphatic metastasis, Breast biopsy, Lymph node biopsy

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