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Taking Repeat Biopsies Necessary for Appropriate Treatment of Breast Cancer Relapses

It is necessary to take biopsies at regular intervals to ensure appropriate treatment of breast cancer. This is because the breast cancer tumors have been found to change their hormonal status throughout the course of disease. This especially holds true in case of a relapse. Normally the treatment is initiated on the basis of one biopsy of the primary tumor. However, it is necessary to verify the nature of the tumor through another biopsy in case of a relapse. These are the findings of a new Swedish study which will be presented at the 2011 European Multidisciplinary Cancer Congress.

The study, led by Dr. Linda Lindström, from the Karolinska Institutet Department of Oncology-Pathology, Solna, Stockholm, is the first big study of its kind to look at changes in tumors in multiple relapses in breast cancer patients. The important finding of the study is that the status of the important tumor markers changes throughout the course of tumor progression. One in three breast cancer patients alter estrogen (ER) or progesterone (PR) hormone receptor status, and 15% of patients change human epidermal growth factor receptor 2, or HER2, status during the course of disease.

The researchers assessed 119 cancer patients in the Stockholm Healthcare Region between 1997 and 2007. The individuals in the study suffered from several relapses during the course of the study. Throughout this period, their ER and PR status was analyzed. It was found that 33.6% of patients had changes in tumor status between the different sites of relapse (local, loco-regional and metastases) whereas 36.1% of the patients were stable ER positive, and 30.3% were stable ER negative. Sixteen percent of patients changed from ER positive to negative during the course of their disease, 12.6% changed from negative to positive, and 5% altered back and forth throughout tumor progression. In the PR group, 30.2% of patients altered their hormone receptor status, with the majority changing from positive to negative.

It is evident from the study that analysis of these tumor markers at periodic intervals is essential to know whether the treatment is progressing in the right direction. Biopsy verification from time to time is necessary as any change in the tumor make-up may completely change the management of the patient. According to Dr. Lindström, tumors other than breast cancer may also be analyzed for similar changes in their make-up. Further studies in this direction may play an important role in the way the relapses are managed.


Sunday, September 25, 2011
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