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 MCG’s 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, called frozen section, would be done during the lumpectomy surgery. If the tissue is positive for cancer cells, the surgeon removes more nodes from the patient, but if it is negative, the surgery is over.”
The problem with that type of test, he says, can come when pathologists review more tissue slices during a confirmatory second test, called a permanent section and done a day later.
Permanent section tests are done the day after surgery because the tissue is set with a fixative that causes proteins in cells to harden for better examination.
“The cancer cells may not have been present in the part of the node that we looked at the day before in the frozen section,” Dr. Peiper says. “But on the second day, we may find them in the other section. We perform both the traditional test and the new GeneSearch molecular test in parallel to provide the best care for our patients.”
The larger the sample, he says, the better the chance of catching the cancer during the intraoperative test.
“If there are small amount s of cancer cells in the whole node, we may or may not see those with the traditional tests, because we only examine a small section of tissue,” he says. “With this technology, we increase the chance of detecting them.”
Nearly 20 percent of women with negative nodes confirmed by a traditional biopsy end up having a recurrence and metastasis, Dr. Peiper says.
“There is a higher false-negative rate with traditional sentinel node biopsies,” says Dr. Scott Lind, professor and chief of the MCG Section of Surgical Oncology. “If that happens, the patient has to come back in for another surgery to take out more lymph nodes that have likely harbored the breast cancer cells.”
In clinical trials, the new test correctly identified more than 95 percent of patients whose cancer had spread to their lymph nodes, according to Veridex, L.L.C.
"This will help us provide better care to patients and better overall treatment,” Dr. Lind says.
Jennifer Hilliard | EurekAlert!
New nanomedicine slips through the cracks
24.04.2019 | University of Tokyo
Sugar entering the brain during septic shock causes memory loss
23.04.2019 | Rensselaer Polytechnic Institute
Flexible, organic and printed electronics conquer everyday life. The forecasts for growth promise increasing markets and opportunities for the industry. In Europe, top institutions and companies are engaged in research and further development of these technologies for tomorrow's markets and applications. However, access by SMEs is difficult. The European project SmartEEs - Smart Emerging Electronics Servicing works on the establishment of a European innovation network, which supports both the access to competences as well as the support of the enterprises with the assumption of innovations and the progress up to the commercialization.
It surrounds us and almost unconsciously accompanies us through everyday life - printed electronics. It starts with smart labels or RFID tags in clothing, we...
The human eye is particularly sensitive to green, but less sensitive to blue and red. Chemists led by Hubert Huppertz at the University of Innsbruck have now developed a new red phosphor whose light is well perceived by the eye. This increases the light yield of white LEDs by around one sixth, which can significantly improve the energy efficiency of lighting systems.
Light emitting diodes or LEDs are only able to produce light of a certain colour. However, white light can be created using different colour mixing processes.
Researchers led by Francesca Ferlaino from the University of Innsbruck and the Austrian Academy of Sciences report in Physical Review X on the observation of supersolid behavior in dipolar quantum gases of erbium and dysprosium. In the dysprosium gas these properties are unprecedentedly long-lived. This sets the stage for future investigations into the nature of this exotic phase of matter.
Supersolidity is a paradoxical state where the matter is both crystallized and superfluid. Predicted 50 years ago, such a counter-intuitive phase, featuring...
A stellar flare 10 times more powerful than anything seen on our sun has burst from an ultracool star almost the same size as Jupiter
A localization phenomenon boosts the accuracy of solving quantum many-body problems with quantum computers which are otherwise challenging for conventional computers. This brings such digital quantum simulation within reach on quantum devices available today.
Quantum computers promise to solve certain computational problems exponentially faster than any classical machine. “A particularly promising application is the...
17.04.2019 | Event News
15.04.2019 | Event News
09.04.2019 | Event News
25.04.2019 | Materials Sciences
25.04.2019 | Earth Sciences
25.04.2019 | Life Sciences