Profile of immune cells in axillary lymph nodes predicts disease-free survival in breast cancer

August 05, 2015

Peter Lee and colleagues (from Stanford University) now report in the open access journal PLoS Medicine that looking at the immune status of lymph nodes might teach us even more about a specific breast tumor. They found that the 'immune profile' (i.e. the number and composition of immune cells) of an axillary lymph node can independently predict the chances that the cancer will come back. This suggests that lymph node immune profiles can help to inform individualized treatment decisions.

The researchers examined 104 axillary lymph nodes from 77 patients. Five-year follow-up data were available for all patients, 33 of whom had disease recurrence within that time. They found that, regardless of whether the nodes contained tumor cells, the numbers of two different sets of immune cells, CD4 T cells and dendritic cells, were correlated with disease-free survival. Moreover, for this group of patients, the predictive power of the immune profiles was better than that of any other clinical parameters, including tumor size and extent or size of lymph node metastases.

All patients in this study had some lymph nodes that contained tumor cells, and the results suggest that for such patients, immune profile data from axillary nodes hold additional information on the probability of disease recurrence. An important open question is whether immune profile information from lymph nodes can predict risk of recurrence even in women whose cancers are caught at a very early stage where they have not yet spread to any lymph nodes.

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The study also found that of the 12,000 lung cancer deaths in 2002 attributed to passive smoking, 73 percent, or 8,800, were among women. Similarly, women accounted for 84 percent, or 39,600, of the 47,000 ischemic heart disease deaths from passive smoking.

"These findings are important because experience has shown that promotion of public awareness of the health effects of passive smoking is one of the best ways to change public perceptions and government policies about smoking in general," said Smith.

The researchers note that the Chinese government is taking encouraging steps towards curbing the country's reputation for lighting up, even as the number of young female smokers appears to be on the rise. At the end of August, the National People's Congress of China ratified the World Health Organization Framework Convention on Tobacco Control (FCTC), an international treaty aimed at curbing tobacco-related death and disease.

The treaty provisions include a ban on tobacco advertising, promotion and sponsorship on radio, television, print media and the Internet within the next five years. Tobacco-company sponsorship of international events and activities, including athletic competitions, is also banned.

"This is a very important step forward for China," said Teh-wei Hu, UC Berkeley professor of health economics and principal investigator of the study. "The Chinese government should also consider raising taxes on cigarettes, which has helped reduce smoking rates in the United States. The hope is that studies such as ours on the health impacts of smoking in China ?? particularly passive smoking ?? will help provide ammunition for the Ministry of Health to implement tougher tobacco control policies."

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