Women with early-stage breast cancer have plenty of procedures and treatments to deal with. So it may come as welcome news that a large clinical trial has found no reason for doctors to perform two tests that were thought to help predict patient survival. Writing in the Journal of the American Medical Assn., the researchers say that the test results are meaningless.
The tests in question involve looking for micrometastasis – microscopic evidence of a breast tumor’s spread – in sentinel lymph nodes and in bone marrow. Some earlier studies had found that women with those micrometastases were more likely to see their cancers recur and/or die of breast cancer sooner. But those studies were retrospective – not the forward-looking studies that researchers prefer. They also involved women with more advanced cases of breast cancer, and some of the studies were so old that they didn’t take into account advances in treatment.
So the American College of Surgeons Oncology Group began this trial in 1999. They recruited 5,119 women from around the country with early-stage breast cancer whose sentinel lymph nodes were examined. In addition, 3,413 of the women had bone marrow biopsies.
The researchers, led by Dr. Armando Guiliano of Cedars-Sinai Medical Center in Los Angeles, found evidence of micrometastasis in 10.5% of the women whose lymph nodes were tested and in 3% of the women whose bone marrow was analyzed. But in both cases, women with microscropic spread of their tumors fared just as well as women without such spread.