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A significant number of patients show discordant quantitative expression of molecular markers between primary breast cancer and nodal metastases
I think that our results could be practice changing. As pathologists, we already have nodal tissue available to us from sentinel node biopsy, axillary sampling, or axillary clearance. We can perform the same tests on these tissues as we already do on the primary tissue. Therefore, although there is a cost associated with this, it is relatively small compared to giving the right drug to the right patient. If a node is HER2+, a woman might benefit from Herceptin. In the clinic treatment decisions could be modified for a few people quite quickly. If ER is lost in the nodes, or decreases expression, it might further explain failure of treatment in the context of large endocrine therapy trials. Ultimately the answer to whether this changes outcomes for women need to be tested in a clinical trial
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Bibliographic Reference:
Dana Faratian Edinburgh Breakthrough Research Unit and Division of Pathology, University of Edinburgh, Edinburgh, UK
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