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Stray Breast Cancer Cells Yield to Post-Op Chemo
Date:8/12/2009

Women with microscopic disease helped by additional treatment, research shows

WEDNESDAY, Aug. 12 (HealthDay News) -- Breast cancer patients with isolated tumor cells or tiny "micrometastases" in the lymph nodes benefit from adjuvant treatment, such as post-surgical chemotherapy or hormonal therapy, a new study finds.

Until now, many doctors doubted that the presence of micrometastases or isolated tumor cells affected long-term recovery, said Dr. Vivianne Tjan-Heijnen, head of the division of medical oncology at Maastricht University Medical Center in the Netherlands, the lead author of the study.

So these patients often are not offered adjuvant therapy after they undergo breast cancer surgery. But the results of her team's study, published in the Aug. 13 issue of the New England Journal of Medicine, suggest they should be.

Micrometastases, which are too small to be seen on standard screening or diagnostic tests, range from 0.2 to 2.0 millimeters in size. Isolated tumor cells or tumor cell groups are even tinier, less than 0.2 millimeters, said Tjan-Heijnen.

To assess the value of additional treatments of chemo or other adjuvant methods, Tjan-Heijnen and her colleagues followed 2,707 women treated surgically for early-stage breast cancer. They were divided into three groups. The first group included 856 women diagnosed with breast cancer whose sentinel node -- the first node the breast tissue drains into -- was negative and cancer-cell free, who didn't get additional treatment. The second group included 856 women diagnosed with breast cancer with cancer cells found in the nodes, but who didn't get additional treatment. The third group included 995 patients with cancer cells found in the nodes who did get additional treatment.

The additional treatment included chemotherapy (such as taxanes), endocrine therapy (such as tamoxifen or aromatase inhibitors), or systemic therapy (both chemo and
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