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    New Test More Effective in Detecting Spread of Breast Cancer

    WebMD Health News

    Sept. 10, 1999 (Montreal) -- Researchers have learned that a new technique to detect hidden tumors in breast cancer patients is more effective than conventional methods. The technique involves testing tissue from underarm lymph nodes and could help physicians better decide what type of treatment to prescribe for individual patients. The study is published in the Sept. 11 issue of the British medical journal The Lancet.

    Lead author Richard Cote, FRCPath, tells WebMD that in postmenopausal women with breast cancer, the test can help identify those who are at the highest risk of their cancer metastasizing, or spreading, and at the highest risk of dying of the disease.

    Once these patients are identified, Cote says doctors can use the information to better target treatments to women who most need it. "It can help define the population of women who need less aggressive forms of adjuvant therapy vs. women who really require a more aggressive approach." Adjuvant therapy is a systemic treatment given to cancer patients after surgery, such as chemotherapy or radiation. Cote is a professor of pathology and urology at the USC/Norris Comprehensive Cancer Center and the University of Southern California School of Medicine in Los Angeles.

    The new technique, called immunohistochemical testing, allows a pathologist to use a highly specific stain that makes cancer cells stand out. When researchers used the test, they detected hidden metastases in 20% of patients, compared to only 7% detected with standard testing. Standard testing involves the use of a stain, but it is not as specific. Regardless of the method of detection, postmenopausal women with hidden metastases were less likely than those without metastases to survive to the end of the 12-year follow-up period and to remain disease-free during this time.

    George Sale, MD, who reviewed the article for WebMD, says the study could impact the way breast cancer patients are monitored. "I think [the results of this article] will influence practice," he says. Sale also says he thinks physicians who read the study will pressure pathologists to use immunohistochemical testing on a more routine basis. Sale is director of the clinical pathology laboratory at Fred Hutchinson Cancer Research Center and a professor at the University of Washington in Seattle.

    Cote's laboratory is currently developing a test that is designed to detect hidden metastases in bone marrow, which could one day help tailor treatment for a wide range of cancer patients.

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