9 August 2013

Test to Detect Spread of Breast Cancer Could Help Avoid Further Surgery

A test used during surgery to detect whether breast cancer has spread can help avoid further operations and allow treatments such as chemotherapy to begin earlier, according to NICE.

In current practice, patients having breast cancer surgery to remove the main tumour, often have some of the lymph nodes from their armpit removed at the same time

A biopsy test is then carried out on the lymph nodes to determine whether cancer cells have spread from the main breast tumour. It can take up to 15 working days to receive results from this biopsy, which if positive, could lead to a second operation to remove the remaining lymph nodes.

Each year around 11,000 people with breast cancer require this additional operation to manage the spread of the disease.

The RD-100i OSNA system is a test that can be used during breast cancer surgery to detect the presence of biological markers which suggest the spread of cancer, in the lymph node biopsy.

NICE says that using this test during surgery can determine whether any lymph nodes that the cancer has spread to should be removed at the same time as the initial tumour.

This means that patients can avoid having to wait for results of biopsies, that additional surgery could be avoided, and that subsequent treatments such as chemotherapy can begin earlier.

The test can also analyse the whole lymph node and so reduce the risk of missing areas that are too small to be seen of where the cancer has spread, known as metastases.

Professor Carole Longson, NICE Health Technology Evaluation Centre Director, said: "For people with breast cancer and their families, waiting to hear if the disease has spread can cause significant distress and anxiety.

"If the test is positive, and a second operation is needed to remove more of the axillary lymph nodes, the second operation can be technically more difficult and result in a higher risk of complications - because it will involve operating on the same area of the breast and armpit as the first operation."

She added: "The Committee heard from a patient expert that the option of not having to have a second operation was an important consideration for patients. The Committee also considered that the accuracy of histopathology may vary depending on the number and size of the lymph node sections examined.

"The Committee therefore concluded that analysis of sentinel lymph nodes using the RD-100i OSNA system during operations had considerable advantages over traditional histopathology testing and had the potential to reduce both clinical complications, and patient anxiety and distress."