A new test that examines large sections of the sentinel lymph node for genes expressed by breast cancer could reduce the risk of recurrence and multiple surgeries, doctors say.
The GeneSearch Breast Lymph Node Assay, manufactured by Veridex, L.L.C., a Johnson & Johnson company, is being used at the Medical College of Georgia to examine half of the tissue in the sentinel lymph node, the first place breast cancer typically spreads. The sample represents more than 10 times the amount of tissue examined in traditional biopsies.
And because the test examines the tissue with molecular tools, it is more sensitive, says Dr. Zixuan (Zoe) Wang, molecular biologist and scientific director of MCGs Georgia Esoteric and Molecular Diagnostic Labs, L.L.C.
When we look at the tissue with the GeneSearch test, we are looking for excessive amounts of mamoglobin and cytokeratin 19, both genes that are expressed more in breast cancer tissue, Dr. Wang says. If those genes are present in excessive amounts, we know the cancer has metastasized.
MCG is the first place in Georgia to offer the test, which Time Magazine named one of the top-10 medical breakthroughs of 2007.
Done during a lumpectomy, the GeneSearch test uses molecular diagnostic methods to examine more tissue than traditional sentinel node biopsies, reducing the chance of false negative results, says Dr. Stephen Peiper, chair of the MCG Department of Pathology and Georgia Cancer Coalition Distinguished Cancer Clinician and Scientist.
The sentinel node, located in the armpit, filters fluid from the breast.
During a traditional sentinel node biopsy, a surgeon would remove a node, then the pathologist would cut that section in half and cut that section to a quarter of the original sample size, Dr. Peiper says. They then would cut wafer-thin slices from those sections, freeze and stain them, and look for cancer cells under a microscope. This technique, call
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Medical College of Georgia