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Topic: metastasis may occur sooner than previously thought

Forum: Stage IV and Metastatic Breast Cancer ONLY —

A place for those managing the ups & downs of a Stage IV/metastatic breast cancer diagnosis. Please respect that this forum is for Stage IV members only. There is a separate forum For Family and Caregivers of People with a STAGE IV Diagnosis.

Posted on: Sep 4, 2008 11:00AM

gandl wrote:

Study suggests cancer cells may metastasize earlier than previously believed.

The U.K.'s Press Association (8/29) reports that a paper appearing in Science suggests that "cancer cells may spread around the body much earlier than was previously thought," a discovery that "could prompt a complete rethink about metastasis...and lead to new ways of tackling the disease." The medical community had previously believed that metastasis was "a late event that only occurs when a disease is advanced and has passed certain stages," after "a series of genetic alterations" made "them more aggressive."

        These changes would ensure the cells' survival as they "journey through the bloodstream," and the alterations would also enable the cells "to initiate malignant growth in their new environment in the new site," the BBC (8/28) added. But researchers at the Memorial Sloan-Kettering Center in New York now maintain that "'normal' cells may carry cancer to new sites long before a tumor develops, lying dormant until key genes are activated." Furthermore, these "cells were capable of traveling in the bloodstream to the lungs" -- some "surviving there for up to 16 weeks without expressing any oncogenes."

        The finding may provide "an explanation for why some breast cancers, for example, appear to spread throughout the body long after the initial tumor has been treated," pointed out the U.K.'s Telegraph (8/28, Highfield). During their experiments, the New York "team injected mice with normal mammary cells from donor mice that had been experimentally manipulated in a way that allowed the researchers to turn on in breast cells certain cancer genes, known as 'oncogenes,' at various times after injection." The "normal mammary cells traveled in the bloodstream to the lungs" for nearly four months, however, they "did not begin growing aggressively in the lungs until the oncogenes had been turned on, by giving the recipient mice a specially treated feed."

        Notably, the cells did not go "through the stage of being a primary tumor," HealthDay (8/28, Gardner) reported. The team led by Harold Varmus, "who won the 1989 Nobel Prize for his work in cancer genetics and later went on to become director of the National Institutes of Health," then "injected normal cells without manipulating any oncogenes." They found that "when these normal ectopic cells were injected back into a new generation of mice, they developed into normal mammary glands." Co-researcher Katrina Podsypanina, Ph.D., said, "It's definitely conceptually very profound," because "our data seems to point toward the inherent decision that is made when the tumor is formed whether it is highly malignant or not." She added, "Moreover, since the characteristic might be dependent on the normal cell status, one might imagine that they might be different between individuals."
gandl multicentric 6 ILC tumors, extensive LCIS, isolated tumor cells in 1 of 6 nodes, bilat mx 2-13-08, arimidex & actonel 2-21-09, switched to aromasin 8-20-09 Dx 1/28/2008, LCIS/ILC, Right, <1cm, Stage IA, 1/6 nodes, ER+/PR+, HER2- Hormonal Therapy Arimidex (anastrozole), Aromasin (exemestane)
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Sep 4, 2008 01:29PM pinoideae wrote:

 This type of research is fascinating, and I hope the key to stopping this hidious disease in its tracks, not only stopping it, eradicating it.  God bless the little mice and the researchers too.

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Sep 4, 2008 08:44PM hutspa wrote:

thank you for posting this.....it is very interesting........



Dx 1/3/2003, IDC, <1cm, Stage IIIA, 5/13 nodes, ER+/PR-, HER2-
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Sep 4, 2008 08:45PM pip57 wrote:

 This addresses my suspicions that there is still so much we need to learn about bc.  Others seem to put so much stock in their staging, especially early cancers, when deciding on tx.  They assume that this disease follows certain known rules and decline tx based on this belief. Of course, the staging is one part of the tx decision, but I have always suspected that there is so much that we don't know. That is probably why so many of our bc sisters have been dx stage IV after having an early staged cancer.  

PIP - multi focal, FEC100/Tax, rads, dble mast with no recon, ooph/hyst, arimidex Dx 2/1/2007, DCIS/IDC, Left, 3cm, Stage IIIB, Grade 2, 9/16 nodes, ER+/PR+, HER2-
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Sep 4, 2008 08:59PM LumiPojo wrote:

That would explain the metastasis cases where no primary tumor was detected. Normal cells from an organ travel to another organ, where they happen to become cancerous, and then spread further. A biopsy would show that the cancer cells are breast cells, for example, and they think that must have been a breast tumor that initiated the spread.

This is soooo complex. So many variables, so many ways in which cancer can be turned on... Years back, a colleague told me that cancer is a probabilistic phenomenon (there is a certain probability that any one cell will become cancerous, at a given time), and as such we will need a lot more math involved in preventing it from occuring. If we could figure out how to prevent a cell from becoming cancerous, even after onset in a certain tissue, then there would be no more mets. If we could figure out a vaccine to also prevent any onset, then it would be goodbye cancer. Forever.

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Sep 4, 2008 09:47PM LisaF wrote:

How interesting!  Do you think this means that chemo should be done for even lower level cancers?    Also, does the newer Oncotype DX take any of this information into consideration?

Sorry if these are silly questions, but I'm just waiting to see if chemo and such is in my future..,

Lisa Dx 6/10/2008, IDC, 2cm, Stage IIA, Grade 2, 0/7 nodes, ER+/PR+, HER2-
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Sep 4, 2008 09:55PM AusAla wrote:

hells bells, I could have told them that!!!!  huge tumor in same spot in breast only six months after lumpectomy, chemo, and full breast rads, plus booster rads....not to mention spread to my skull, spinal cord lining and lower back.  Moved AND grew back sooner than I ever expected.

"I don't want to be in a battle, but waiting on the edge of one I can't escape is even worse! Pippin, Lord of the Ring: Return of the King Dx 5/13/2002, IDC, 2cm, Stage IV, Grade 3, 3/17 nodes, mets, ER+/PR+, HER2+
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Sep 4, 2008 10:49PM - edited Sep 4, 2008 10:54PM by Gitane

LisaF,  The questions you are asking are the same as mine.  I found this on the web. These are the presentations that were made at the Southwest Oncology Group Meeting this spring.  There is a slide that is part of the presentation made by Kathy Albain.  The title on the slide is "Comparison of CAF-T to Tamoxifen Alone,  DFS adjusted for nodal Status"  It shows SWOG 8814 patients DFS rates broken down by Oncotype DX RS and for "First 5 Years" and "Greater than 5 Years"  Looking at this slide it appears that Low RS patients treated with Chemo benefit from that chemo treatment in the "Greater than 5 Years" period just like the Intermediate and High RS groups.  If you get a chance to look at this, tell me what you think.


Group Meeting   The following presentations were given at the Plenary Session of the Spring 2008 Group Meeting in Atlanta, Georgia, "Southwest Oncology Group Showcase 2008." They are in Windows Media Video format, and should automatically start in the default player for .wmv files on your computer when you click the icon at the right of the presentation title. 

SWOG-8814: Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal, node-negative, ER-positive breast cancer (SWOG-8814, TBCI-0100) 

Kathy S. Albain, M.D.

Professor of Medicine, Hematology and Oncology, Loyola University, Maywood, Illinois 

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