Download Tests for Breast Cancer

Tests for Breast Cancer:
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Acueity ductoscopy is a patented optical system and ductoscope, about the size of a pencil tip,
enable physicians to look through the nipple directly into the milk ducts -- areas previously
inaccessible to medical intervention -- where 85% of breast cancer develops. Their system of
microendoscopes, coupled with patented OptiCueTM optical technology results in large, clear and
sharp video images of the mammary duct system, with unprecedented depth of field perception
and detects lesions as small as 0.2 mm in diameter (50 times more sensitive than a standard
mammogram). Go to http://www.acueity.com/for more information.
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Amas test (see above): This test can be the first choice to check for breast cancer. The AMAS
test detects malignant growth only (not benign tumors) and is more sensitive than mammograms.
If the AMAS is positive, further tests are warranted as the AMAS doesn't indicate Where the
cancer is located, only that there is cancer within the body. In addition, the AMAS test can be
used to follow breast cancer patients who are in remission, since the AMAS returns to normal
within 3 months after the breast tumor (and metastases, if present) are removed or eradicated.
AMAS - Anti-malignin antibody screen test is designed to pick up cancers well in advance of
other signs and symptoms, months before conventional medical tests can detect it. However, for
advanced cancer, if the antimalignin antibody is wiped out, the test won't work. For this, other
types of testing is recommended. We have also heard of a few breast cancer patients have
received a false negative on this test. Again, it is important not to rely on any one test. Oncolab
will send a free test kit for you to take to your doctor. The test runs $125 in addition to your
doctor's office charges for drawing blood. Call 1-800-9CATest for a test kit and information.
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Cancer Marker Tests - CA 15.3 and CA125 (above).
Cancer Marker Tests: These are immunological methods - cancer markers that are produced as cancer
grows and are detectable even before it reaches a size big enough for detection by other methods. This
early detection system is vital for early medical intervention that significantly improves the chances of
recovery. http://www.pathlab2u.com/s-cancer.shtml discusses these markers, which include:
CA 15.3 values are often elevated in patients with breast cancers. When there is a history of
cancer among family members, patients may be advised to also do a breast mammogram.
Besides breast cancer, other non-malignant conditions (eg. cirrhosis, benign diseases of ovaries
& breast) have also been known to cause elevated CA 15.3 levels.
CA125 has become a widely used tumor marker which is measured most often in women with
cancers of the reproductive system including the uterus, fallopian tubes and ovaries. Other
cancers that may cause abnormal CA125 levels include cancer of the pancreas, lungs, breast
and colon. However, CA125/CA125-II can be elevated during menstruation, pregnancy or in
individuals with ovarian cysts, pericarditis, hepatitis, cirrhosis of the liver or peritonitis, an
infection of the lining of the abdomen, and even in 1-2% of healthy individuals. Once a cancer is
diagnosed, CA125/CA125-II levels may prove to be an effective indicator of the effectiveness of
cancer treatment. A declining CA125/CA125-II value may indicate a good response to treatment
and a favorable prognosis. Persistently rising CA125/CA125-II levels may be associated with a
growing tumor, presence of tumor on the peritoneum that lines the abdomen or a recurrence of
a previously treated tumor. Additional evaluation is necessary to make such determinations. CA
125-II, an improved version of the original CA 125 assay, is now commercially available. Ask
your doctor or contact Life Extension Foundation
athttp://www.lef.org/bloodtest/bloodtest2.html or 800-208-3444.
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DR-70 is a simple blood test - (See above).
DR-70 is a simple blood test that screens for 13 different cancers at the same time. It is highly
specific and catches cancer long before you would suspect anything was amiss. It runs about
$100. Cancers that can be detected by the test are of the lung, colon, breast, stomach, liver,
rectum, ovary, cervix, esophagus, thyroid, and pancreas, and trophoblast and malignant
lymphoma. AMDL has also received clearance from the FDA to market the PyloriProbe™ test,
which can detect the presence of Helicobacter Pylori in the stomach, the primary cause of
ulcers and a potential cause of stomach cancer. For more info on the test, contact AMDL Inc., in
Tustin, California by calling 714-505-4460, or email them at: [email protected], or go to their
website at www.amdl.com. We are attempting to get information on the accuracy of this test.
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Ductal lavage is a new test similar to the Pap smear, and was developed by Dr. Susan Love. It is
a simple blood test and an infrared imaging system that samples the lining of ducts of the breast
to see what the cells are doing and to detect precancerous abnormalities or cancer cells. The
procedure has been dubbed "Pap smear for the breast" because, like the test for cervical cancer,
it is a non-surgical approach to identifying abnormal cells, potentially making it possible to find
them when they are just thinking about becoming cancer.
Mammography/Thermography - Mammograms can detect many breast cancers, but there is
concern over false results and the hazards of radiation exposure that result from the tests. There
are two new forms of mammography that are making news: Computed Tomography Laser
Mammography and Full Field Digital Mammography.
The CTLM - Computed Tomography Laser Mammography system uses state-of-the-art laser
technology, a special array of detectors and proprietary computed algorithms. The CTLM ® system
does not expose the patient to ionizing radiation or require breast compression. This approach is
awaiting FDA approval.
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Digital mammography still uses low energy x-rays that pass through the breast exactly like
conventional mammograms but are recorded by means of an electronic digital detector instead of
the film. This electronic image can be displayed on a video monitor like a TV or printed onto film.
The radiologist can manipulate the digital mammogram electronically to magnify an area, change
contrast, or alter the brightness.
Another test being developed is a blood test to detect a protein marker for breast cancer. The
test apparently can pick up cancerous tumors and pre-cancerous conditions. It is awaiting FDA
approval.
Thermography can determine precancerous changes at an earlier, and theoretically more
treatable, stage—months or even years before those changes would be felt as a lump or be
visible on a mammogram, and all without radiation. The While mammography relies primarily on
finding the physical tumor, thermography uses thermal imaging which detects new blood vessels
and chemical changes associated with a tumor’s genesis and growth. For more information, go to
the section on Thermography above. The test, however, may not be approved by your insurance
as it is still considered controversial. For for a list of places that offer go to our breast
thermographypage.
T/Tn Antigen Test (see below)
T/Tn Antigen Test developed by Dr. Georg Springer can detect the majority of cancers before
any biopsy can pick up the presence of cancer. The T and Tn antigens are proteins on the
surface of blood and skin cells and can be identified by the immune system antibodies. The
concentration of these antigens vary depending on the cancer type and stage. A skin prick can
predict or indicate the likely development of cancers, even 6-10 years in advance of other tests.
The test appears to successfully diagnosis about 94% of lung cancers and 80% of breast
cancers. More information about the test can be obtained by calling the Chicago Medical School
at (847) 578-3435.
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Ultrasound or sonogram can be used to determine whether a lump is a cyst (containing fluid)
or a solid mass and to precisely locate the position of a known tumor. The test is safe and
painless, and uses no radiation.
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Other Imaging Methods:
A number of other imaging methods are now available for detecting breast cancer. At present,
they are used mainly in research studies, and sometimes to get more information about a tumor
found by another method. Each of these new methods generates a computerized image that the
doctor can analyze for the presence of an abnormal breast lump. These include:
Scintigraphy [sin-TOG-ra-fee]
Also called scintimammography, this test uses a special camera to show where a tracer (a
radioactive chemical) has adhered to a tumor. A scanner is then used to see if the breast lump
has picked up more of the radioactive material than the rest of the breast tissue. Dr.
Fleming in Omaha has been using this approach. There are also
clinical trials for this approach.
MRI
A magnetic resonance imaging (MRI) machine uses a large magnet and radio waves to measure
the electromagnetic signals your body naturally gives off. It makes precise images of the inside of
the body, including tissue and fluids. MRI can also be used to see if a silicone breast implant has
leaked or ruptured.
PET scan
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Cancer cells grow faster than other cells, so they use up energy faster, too. To measure how fast
glucose (the body's fuel) is being used, a tracer (radioactive glucose) is injected into the body and
scanned with a positron emission tomography (PET) machine. The PET machine detects how
fast the glucose is being used. If it is being used up faster in certain places, it may indicate the
presence of a cancerous tumor.
Mayo Clinic researchers are working on a new imaging test called magnetic resonance (MR)
elastography. This test uses a combination of sound waves and MRI to evaluate the mechanical
properties of tissues within the breast. "Conventional MRI is very sensitive for detecting breast
cancer, but unfortunately there are too many false positives," Dr. Ehman says. "The goal of our
research is to determine whether we can use this new MR elastography technique to improve the
accuracy of MRI for breast cancer diagnosis, thereby reducing the need for biopsies." In addition,
mammography does not work as well for women with dense breasts, those who have had
lumpectomies or premenopausal women,. The combination of MRI and MR elastography could
be used as an additional screening tool.
Additional Tests to see if cancer has spread:
To find out if cancer has spread, additional tests may need to be performed to see if the cancer
has spread to other organs or the bones. Some doctors will do x-rays, blood tests, CATs or MRIs,
and bone scans. If one does not want biopsies of the lymph nodes, some believe the Pet or CT
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scan is a good alternative. In addition, biopsies can be used to see if a lump is cancerous or if it
has spread to the lymph nodes. A new form of biopsy is the Mammotome® Breast Biopsy
System.
Mammotome® Breast Biopsy System is an image guided procedure (stereotactic or
ultrasound) that helps physicians locate breast abnormalities and obtain tissue samples for
diagnosis. Unlike other biopsy methods, the Mammotome is capable of sampling a variety of
breast abnormalities with just one small incision and requires no sutures. However, it still uses xrays to help guide the procedure. Go to http://www.breastinfo.com/mbiopsy.htm for more
information. (Note: Because there is always the possibility of the cancer spreading, we still
recommend less invasive approaches above.)
RESOURCE: http://www.cancure.org/tests_to_detect_cancer.htm
Blood Marker Tests
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Page last modified on: May 17, 2010
Your doctor may order blood tests for cancer/tumor markers to detect cancer activity in the
body. Proteins and circulating tumor cells are two types of markers that can be measured.
A cancer tumor often produces a specific protein in the blood that serves as a marker for
the cancer. Circulating tumor cells are cells that break off from the cancer and move into the
blood stream. Protein markers and circulating tumor cells can be measured with simple
blood tests.
Blood marker tests may be done before treatment, to help diagnose the breast cancer and
determine whether it's moved to other parts of the body; during treatment, to assess
whether the cancer is responding; and after treatment, to see if the cancer has come back
(recurrence).
Examples of your doctor may test for include:
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CA 15.3: used to find breast and ovarian cancers
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TRU-QUANT and CA 27.29: may mean that breast cancer is present
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CA125: may signal ovarian cancer, ovarian cancer recurrence, and breast cancer
recurrence
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CEA (carcinoembryonic antigen): a marker for the presence of colon, lung, and liver
cancers. This marker may be used to determine if the breast cancer has traveled to other
areas of the body.
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Circulating tumor cells: cells that break off from the cancer and move into the blood
stream. High circulating tumor cell counts may indicate that the cancer is growing. The
CellSearch test has been approved by the U.S. Food and Drug Administration to monitor
circulating tumor cells in women diagnosed with metastatic breast cancer.
Some doctors use marker test results as early indicators of breast cancer progression (the
cancer getting worse) or recurrence. They may use this information to make decisions
about when to change therapies — if current treatment does not appear to be working — or
to start treatment for recurrence. If you have an elevated marker, your doctor may check
that marker periodically to assess your response to chemotherapy or other treatments.
While breast cancer blood marker tests are promising, they're not absolutely conclusive.
When a breast cancer blood marker test comes back negative, it doesn't necessarily mean
you're free and clear of breast cancer. And a positive result doesn't always mean that the
cancer is growing. These tests may help with diagnosis, but using cancer marker tests to
find metastatic breast cancer hasn't helped improve survival yet.
When deciding if you should get tested for breast cancer blood markers, there are some
things you may want to consider:
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cost — the tests can be expensive
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anxiety — not just from an elevated blood marker, but by all the tests you may need to
find out what's causing the marker to go up
Talk to your doctor about the possible benefits and risks of blood marker testing in
your unique situation.
RESOURCE: http://www.breastcancer.org/symptoms/testing/types/blood_marker.jsp
Breast Cancer
Overview | Signs & Symptoms | Testing | Prevention | Early Detection | Treatment | Related Pages
Testing
The goals of breast cancer testing are to identify genetic risk in high risk patients, detect and diagnose breast cancer
in its earliest stages, determine how far it has spread, evaluate the cancer’s characteristics in order to guide
treatment, monitor the effectiveness of treatment, and monitor the woman over time to detect and address any cancer
recurrences. The table below summarizes various breast cancer tests. Detailed discussions of the tests follow the
table.
Expand TableTests
for Breast Cancer
TEST
Her 2/neu
DIAGNOSIS, PROGNOSIS, TREATMENT
Patients with increased levels respond well to Herceptin and have a good
TEST
SAMPLE
Tissue
prognosis.
Estrogen Receptor/
Increased levels suggest a good prognosis in response to anti-hormone therapy.
Tissue
CA15-3/ CA27.29
Elevated blood levels of cancer antigens may indicate recurrence of cancer.
Blood
BRACA-1 / BRACA-2
Genetic markers, if present, suggest an 80% likelihood of breast cancer
Blood
Progesterone
Receptor
occurrence.
Oncotype DX
May assist in determining risk of recurrence and predict who will benefit from
hormone therapy or chemotherapy.
Tissue
TEST
MammaPrint(Agendia)
DIAGNOSIS, PROGNOSIS, TREATMENT
May assist in determining whether a patient is at risk for possible metastasis of
TEST
SAMPLE
Tissue
cancer.
DNA Ploidy
Determines rate of tumor cell growth (S phase) which, if elevated, suggests poor
Tissue
prognosis. May require chemotherapy.
Ki-67 Antigen
Elevated levels measure rapid tumor cell growth, thus suggests a poor prognosis. Tissue
Ductal lavage
Presence of abnormal cytology (abnormal looking cells) may be a useful
N/A
screening tool in identifying cancer.
Mammogram
Highly-sensitive digital X-ray technology that may detect small lumps that
N/A
otherwise would not be detected through self-exam.
Laboratory Tests
Laboratory tests for breast cancer can be broken down into groups, based on the purpose of testing:
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To diagnose: cytology - a microscopic examination of tumor cells obtained through fine needleaspiration and
surgical pathology - a microscopic examination of tissue sampling via biopsy
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To determine treatment options: evaluation of the tumor's HER-2/neu gene amplification status and estrogen
and progesterone receptor status
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To monitor treatment and for recurrence: measurement of CA 15-3 or CA 27.29 in the blood
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To determine genetic risk in high risk patients: blood testing for mutations that may be present in the BRCA-1
and BRCA-2 genes
Some tests for breast cancer are performed on the patient's blood; others are done on a sample of cells or the tumor
tissue.
Cytology and surgical pathology
When a radiologist detects a suspicious area, such as calcifications or a non-palpable mass on amammogram, or if a
lump has been found during a clinical or self-exam (see Non-Laboratory Tests below), a doctor will frequently order a
needle or surgical biopsy or a fine needle aspiration. In each case, a small sample of tissue is taken from the
suspicious area of the breast so that a pathologist can examine the cells microscopically for signs of cancer. This
pathological examination is done to determine whether the lesion is benign or malignant.
Malignant cells show changes or deviations from normal cells. Signs include changes in the size of cell nuclei and
evidence of increased cell division. Pathologists can diagnose cancer based upon the observed changes, determine
how abnormal the cells appear, and see whether there is a single type of change or a mixture of changes. These
results help guide breast cancer treatment.
Needle aspirations are limited due to the small sample that is obtained. A tissue biopsy is needed to determine if a
cancer is early stage or invasive. When a breast cancer is surgically removed (seeTreatment), cells from the tumor
and sometimes from adjacent tissue and lymph nodes are examined by the pathologist to help determine how far the
cancer has spread.
Tests performed on tumor tissue
If the pathologist's diagnosis is breast cancer, there are several tests that may be performed on the cancer cells. The
results of these tests provide a prognosis and help the oncologist (cancer specialist) guide the patient’s treatment.
The most useful of these are HER-2/neu and estrogen and progesterone receptors.
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Her-2/neu is an oncogene . It codes for a receptor for a particular growth factor that causes cells to grow.
Normal epithelial cells contain two copies of the Her-2/neu gene and produce low levels of the Her-2 protein on
the surface of their cells. In about 20-30% of invasive breast cancers, the Her-2/neu gene is amplified and its
protein is over-expressed. These tumors are susceptible to treatment that specifically binds to this overexpressed protein. The chemotherapeutic agent Herceptin (Tastuzumab) blocks the protein receptors, inhibiting
continued replication and tumor growth. Patients with amplified Her-2/neu gene respond well to Herceptin and
have a good prognosis.
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Estrogen and progesterone receptor status are important prognostic markers in breast cancer. The higher
the percentage of overall cells positive, as well as the greater the intensity, the better the prognosis. Estrogen
and/or progesterone receptor positivity in breast cancer cells indicates sensitivity to hormones. The patient may
be a good candidate for anti-hormone therapy.
Blood tests
Blood tests may be used to help determine whether or not the tumor is responding to therapy or if it has recurred.
Some may be ordered on women who are at a high risk of developing breast cancer to determine whether their risk
has a genetic component.
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CA15-3 (or CA 27.29) is a tumor marker that may be ordered at intervals after treatment to help monitor a
patient for breast cancer recurrence. It is not used as a screen for breast cancer but can be used to follow it in
some patients once it has been diagnosed.
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BRCA-1 or BRCA-2 gene mutation – Women who are at high risk because of a personal or strong family history
of early onset breast cancer or ovarian cancer can find out if they have a BRCA gene mutation. A mutation in
either gene indicates that the patient is at significantly higher lifetime risk (up to 80%) for developing the
disease. It is important to remember, however, that only about 5% to 10% of breast cancer cases occur in
women with a BRCA gene mutation. Genetic counseling should be considered both before testing takes place
and after receiving positive test results.
Other tests
There are several tests available, and many others being researched, that evaluate large numbers of genetic patterns
in breast cancer tumor tissue. These tests are being investigated as predictive tests for the recurrence of breast
cancer and therapy outcome. The American Society of Clinical Oncology (ASCO) mentioned several of them in its
recent “2007 Update of Recommendations for the Use of Tumor Markers in Breast Cancer” and some have been
included in the National Comprehensive Cancer Network’s 2008 Breast Cancer Treatment Guidelines. In most cases,
the tests were deemed promising, but data to support their routine clinical use were still thought to be insufficient.
Examples of tests being ordered by some doctors include:
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Oncotype DX – ASCO indicates that this test, which measures 21 genes, can be used to predict risk of cancer
recurrence in patients who have been newly diagnosed with early breast cancer, have cancer-negative lymph
nodes, have estrogen receptor positive tumors, and are taking the drug tamoxifen.
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MammaPrint test – in use in Europe and recently cleared by the FDA for use in the U.S. This test evaluates
gene activity patterns in 70 tumor genes. It may be used to help predict whether a breast cancer will recur
and/or metastasize in women who have early stage cancer, are under the age of 61, and have cancer-negative
lymph nodes.
There are additional tests that may be used in some breast cancer cases, such as DNA ploidy, Ki-67, or other
proliferation markers. However, most authorities believe that HER-2/neu, estrogen and progesterone receptor status
are the most important to evaluate first. The other tests do not have therapeutic implications and, when compared
with grade and stage of the disease, are not independently significant with respect to prognosis. Some medical
centers use these tests for additional information in evaluating patients, making it important to discuss the value of
these tests with your cancer management team.
Non-Laboratory Tests
In addition to laboratory tests, there are non-laboratory tests that are equally important. These include:
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Mammography is widely recommended as a screening tool. A screening mammogram uses X-ray technology to
produce an image of the breasts and can reveal breast cancer up to two years before a lump is large enough to
be felt during a clinical or self-exam.
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Newer technologies, such as digital mammography and computer-aided detection, may yield a clearer image
than a mammography in some cases. In particular, younger women, whose breast tissue is often too dense to
show tumors clearly on the X-ray film used for a standard mammogram, may benefit from ultrasound exams or
magnetic resonance imaging (MRI).
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Ductal lavage may also be used as a screening tool, particularly for women at high risk for developing the
disease. In this procedure, a doctor extracts cells via a tiny tube inserted through the patient's nipple. Those
cells are then examined for signs of cancer.
For more information on mammography and other imaging technologies, go to the National Cancer Institute’s
website or the College of American Patholgists website.
Blood Cell Counts
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Before and during treatment for breast cancer, your doctor likely will order blood cell counts.
These tests check to see whether the blood has normal amounts of various types of blood
cells. The cancer itself and treatments such as chemotherapy and radiation therapy can
reduce the levels of important blood cells your body needs to function properly.
Blood cell counts typically measure:
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white blood cells, which function as the immune system cells that defend your body
against foreign substances and “invaders.” If you have a low white blood cell count, you
have a higher risk of getting an infection.
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red blood cells, which carry oxygen throughout the body. In addition to measuring the
number of red blood cells, a test will be done to measure the level of hemoglobin, an
iron-rich protein found in red blood cells that carries oxygen from your lungs to the rest of
your body. (When you have low hemoglobin levels, a condition called anemia can result.)
Another test will measure your hematocrit level, which is the fraction of whole blood
volume that consists of red blood cells.
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platelets, which are cells that help your blood form clots to prevent bleeding
Before treatment begins, blood cell counts may be used to determine whether you have
another medical condition, such as anemia, that needs to be addressed first. Abnormal
counts also could be an indication that the cancer has spread to the bone marrow (the
spongy tissue inside bones where blood cells are made).
During treatment with chemotherapy, your blood cell counts will be checked before each
cycle of treatment. Chemotherapy medications can significantly reduce the levels of blood
cells your body should have. Radiation therapy can affect these levels as well, although to a
lesser extent. Blood counts may be checked during a course of radiation, particularly if the
radiation is being given to a large area or if you've just had or are still having chemotherapy.
If your counts are too low, your doctor can give you medications called growth factors to
stimulate the growth of certain types of blood cells. Examples of growth factors include:
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Procrit (chemical name: epoetin alfa), Epogen (chemical name: epoetin alfa), or Aranesp
(chemical name: darbepoetin alfa) to increase red blood cell counts
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Neumega (chemical name: oprelvekin) to increase platelet counts
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Neupogen (chemical name: filgrastim) to boost white blood cell levels
Another option is a transfusion, which is the process of transferring healthy blood or needed
blood components into your body.
After treatment, blood tests are used to look for signs of recurrence and to monitor possible
side effects from medication. Counts of white blood cells (immune cells) and platelets are
taken until they are back to normal. Then, your doctor will probably order blood counts only
occasionally, depending on the kind of treatment you’ve had and how you are feeling.
http://www.breastcancer.org/symptoms/testing/types/blood_counts.jsp
FDA approves new breast cancer lab test
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July 17, 2007
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The U.S. Food and Drug Administration has approved the first molecular-based
laboratory test for detecting whether breast cancer has metastasized.
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The GeneSearch BLN Assay test approved Monday detects molecules that are abundant in
breast tissue but are scarce in a normal lymph node.
The FDA said the presence or absence of breast cancer cells in underarm lymph nodes is a
strong predictor of whether the cancer has spread and is used to help decide appropriate
therapy for women with metastatic breast cancer.
"The GeneSearch BLN Assay offers a new approach to sentinel node testing," said Dr.
Daniel Schultz, director of the FDA's Center for Devices and Radiological Health. "Results
of this rapid test are available while patients are on the operating table, providing a way for
some women to avoid a second operation."
The GeneSearch BLN Assay is manufactured by Veridex, a Johnson & Johnson subsidiary
located in Warren, N.J.
http://www.physorg.com/news103890702.html