Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New way to assess risk of breast cancer recurrence developed at Stanford

06.09.2005


Currently, the best way to predict whether a breast cancer is likely to recur is to determine whether tumor cells have invaded the lymph nodes near the breast. But new research from the Stanford University School of Medicine suggests that looking at the immune cells in those lymph nodes - instead of the tumor cells - will yield a more accurate forecast. The finding could help clinicians determine which cancers to treat more aggressively to ensure the cancer goes away and doesn’t come back.



"Immune changes in the lymph node almost perfectly predict clinical outcome, much better than any other prognostic factor that is available today," said Peter P. Lee, MD, assistant professor of medicine and the senior author of the paper detailing the findings in the Sept. 6 advance online edition of Public Library of Science-Medicine.

In samples of breast cancer patients’ lymph nodes, Lee and his colleagues identified unique patterns of immune cells. When the researchers compared the immune profiles to whether a patient’s cancer returned within five years, they could divide the patients into two groups. The group with what Lee termed a "favorable" immune profile had an 85 to 90 percent chance of being disease-free after five years. The group with an "unfavorable" immune profile had less than a 15 percent chance.


The predictions could be made solely based on the immune cells, regardless of whether a lymph node contained tumor cells.

The origins of the study can be traced to about three years ago, when Lee began to question why the lymph node’s immune cells didn’t react to and destroy the invading tumor cells. He reasoned that tumor cells must do something to suppress the immune cells in the node. He wanted to see if he could identify changes in the immune cells in the lymph nodes of women who had breast cancer. If so, he wondered if it could predict how the women fared years later.

Lee enlisted Holbrook Kohrt, MD, a resident in internal medicine, to scour the Stanford pathology bank, looking for preserved samples of lymph nodes. They obtained lymph node tissue samples from 77 breast cancer patients taken more than five years ago. All of these patients had had cancer that migrated out of the breast. Each also had five-year follow-up information.

Using specific antibodies, they looked for three major types of immune cells: cytotoxic T cells, helper T cells and dendritic cells as well as tumor cells. Using an automated imaging system, they collected up to 4,000 images per lymph node, allowing them to count cells from the entire lymph node. Previous studies have relied on fewer than 20 images.

Lymph nodes that were invaded by tumor cells showed dramatic decreases in helper T cells and dendritic cells. They also had fewer cytotoxic T cells.

"That finding was interesting, but somewhat intuitive," said Lee. He said it is logical to think that with tumor cells accounting for up to 80 percent of the cells in an invaded lymph node, there are bound to be some perturbations in immune cell populations.

"Then we found something more interesting and puzzling," he said. Some of the nodes were only minimally invaded by tumor cells-in some cases fewer than 10 tumor cells or even without a single tumor cell to be found. These lymph nodes also showed similar immune changes as nodes full of tumor cells. Statistician Susan Holmes, PhD, rigorously analyzed the data and found that strikingly, immune changes within these lymph nodes predicted clinical outcome even better than their tumor invasion status.

In other words, the numbers of immune cells alone seemed to predict whether a woman’s cancer returned within five years. In the study, 33 of the 77 patients had their cancer return.

"It was a surprise to find immune changes in lymph nodes with no detectable tumor cells," said Lee. He added that their data support an intriguing theory: Perhaps tumor cells prepare the lymph node for invasion. "Even before it actually invades the node, it actually causes the node to change," he said. It might be a more sensitive and earlier method of detecting metastasis, or tumor spread, than actually seeing the migrated tumor cells themselves.

Such information could help determine which women could benefit from more aggressive therapy, and which could be spared undergoing costly and toxic treatments unnecessarily.

"The nice thing about this technique is that it could be applied to all women with breast cancer," said Kohrt, the lead author of the paper. "It’s awesome that such a simple idea could affect more than 200,000 patients a year."

Lee envisions a simple clinical tool based on their discovery: it entails staining a lymph node biopsy for immune cells rather than for tumor cells. The researchers emphasize that their findings will have to be confirmed with larger numbers of breast cancer patients, in those with less advanced disease and with fresh samples rather than frozen.

From the broader perspective of cancer biology in general, the group’s findings underscore the importance of immune response in determining the spread of breast cancer. A better understanding of these mechanisms may lead to novel treatment strategies for breast cancer specifically directed at modulating the immune responses within lymph nodes.

"This is a shot in the arm for the field," said Kohrt. "The immunology of breast cancer has not been very well explored yet, and these findings argue that the immune system is more important in cancer than previously thought."

Mitzi Baker | EurekAlert!
Further information:
http://www.stanford.edu

More articles from Life Sciences:

nachricht Multi-institutional collaboration uncovers how molecular machines assemble
02.12.2016 | Salk Institute

nachricht Fertilized egg cells trigger and monitor loss of sperm’s epigenetic memory
02.12.2016 | IMBA - Institut für Molekulare Biotechnologie der Österreichischen Akademie der Wissenschaften GmbH

All articles from Life Sciences >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

Im Focus: Molecules change shape when wet

Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water

In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...

Im Focus: Fraunhofer ISE Develops Highly Compact, High Frequency DC/DC Converter for Aviation

The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.

Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

UTSA study describes new minimally invasive device to treat cancer and other illnesses

02.12.2016 | Medical Engineering

Plasma-zapping process could yield trans fat-free soybean oil product

02.12.2016 | Agricultural and Forestry Science

What do Netflix, Google and planetary systems have in common?

02.12.2016 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>