Researchers have developed a rapid automated approach to lymph node analysis that may allow for more accurate evaluation of the sentinel lymph node during surgery. These results were published in the Annals of Surgery.
For over 30 years, the standard for early breast cancer staging has included the removal of approximately 10 to 25 axillary (under the arm) lymph nodes to help determine whether the cancer has spread. This procedure, called an axillary lymph node dissection (ALND), can be associated with chronic side effects, including pain, limited shoulder motion, numbness, and swelling.
A more recent approach to evaluate whether cancer has spread to the lymph nodes is sentinel lymph node biopsy. The advantage of this procedure is that only a small number of sentinel nodes (or even a single node) are removed. Sentinel nodes are the first lymph nodes to which cancer is likely to spread.
Sentinel lymph node biopsy is becoming more widely adopted in the clinical setting for determining whether cancer has spread to the lymph nodes in women with localized breast cancer.
If cancer is found in the sentinel lymph node, women generally undergo ALND. In order for both of these procedures to be performed during a single surgery, physicians must be able to quickly and accurately evaluate the sentinel node for cancer. Researchers have therefore developed an automated (but still experimental) tool to examine the sentinel node during surgery.
The researchers developed the tool by looking for markers of gene expression that distinguished lymph nodes with and without cancer. They discovered that a test for two markers identified the nodes with cancer with high accuracy. Furthermore, the test could be completed in less than 35 minutes.
The researchers conclude “While this assay may have the potential to eventually replace current methods of lymph node analysis, further investigation is necessary and it is currently applicable only as a research tool.”
Reference: Hughes SJ, Xi L, Raja S et al. A Rapid, Fully Automated, Molecular-Based Assay Accurately Analyzes Sentinel Lymph Nodes for the Presence of Metastatic Breast Cancer. Annals of Surgery. 2006;243:389-398.
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