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 Antimicrobial substances identified in Komodo dragon blood
23.02.2017 | American Chemical Society

nachricht New Mechanisms of Gene Inactivation may prevent Aging and Cancer
23.02.2017 | Leibniz-Institut für Alternsforschung - Fritz-Lipmann-Institut e.V. (FLI)

All articles from Life Sciences >>>

The most recent press releases about innovation >>>

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

Im Focus: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

From rocks in Colorado, evidence of a 'chaotic solar system'

23.02.2017 | Physics and Astronomy

'Quartz' crystals at the Earth's core power its magnetic field

23.02.2017 | Earth Sciences

Antimicrobial substances identified in Komodo dragon blood

23.02.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>