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NICE approves new test for spread of breast cancer

"Instant breast cancer test approved that will save women weeks of waiting for results," reports the Daily Mirror, while the Daily Mail points out that the test could "spare thousands of sufferers the ordeal of repeat surgery"…

"Instant breast cancer test approved that will save women weeks of waiting for results," reports the Daily Mirror, while the Daily Mail points out that the test could "spare thousands of sufferers the ordeal of repeat surgery".

The test in question is called RD-100i OSNA, and is used during surgery to remove invasive breast cancer. This new test can tell doctors whether the cancer has spread to the lymph nodes. It does this by detecting abnormal genetic markers in samples taken from the lymph nodes. The test is expected to provide much faster results than conventional biopsies.

The test has now been recommended by the National Institute for Health and Care Excellence (NICE), which advises which treatments should be available on the NHS. It is expected to be introduced for patients selected to have surgery for early breast cancer. NICE says that the test can help avoid further operations and allow treatments such as chemotherapy to begin much earlier.

 

An 'instant' test?

It's worth noting that this test is not the kind of "instant" test for initial diagnosis that your GP or nurse will be able to carry out at your local practice. The new test also will not become part of a screening programme.

 

This test is carried out on people having surgery for breast cancer that has already been diagnosed.

How does the new test work?

Breast cancer can spread directly into surrounding tissue or through the bloodstream. However, it most commonly spreads through the lymph system.

The lymph system is made up of a network of vessels (channels) and glands called lymph nodes. Breast cancer most often first spreads to the lymph nodes in the armpits (axillary lymph nodes).

Currently, during surgery to remove a breast tumour the patient usually has one or more lymph nodes from the armpit removed at the same time. These are then sent to a laboratory for analysis.

The newly approved test, called RD-100i OSNA system, is a kind of biopsy that examines the genetic material of the lymph node for the presence of biological markers that indicate that the cancer has spread.

The new test looks at the lymph node DNA to detect "gene expression" for cytokeratin-19 (CK19), a protein (or marker) associated with breast cancer. Gene expression is the process through which the information encoded in our genes is used to produce proteins.

Measuring the level of gene expression shows how active the gene is. The results are available immediately, allowing surgeons to remove more tissue from the lymph nodes if the results suggest that the cancer has spread.

NICE says the test can be used to analyse the whole lymph node, reducing the risk of missing areas that are too small to be seen. This may help reduce the need for subsequent operations.

 

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