ChromaVision Medical Systems, Inc, announced recently that investigators using their automated cellular imaging system (ACIS) concluded that the number of metastatic tumor cells found in the sentinel lymph node correlates with the size of the primary breast tumor. The data, which were presented at the 24th Annual San Antonio Breast Cancer Symposium, showed that sentinel nodes from patients with small primary tumors have fewer tumor cells and would require more extensive sectioning to detect metastases.
When cancer is diagnosed at an early stage, tumor analysis can be performed while the tumor is still relatively small. According to ChromaVision, the ACIS digital microscope platform makes it practical to examine a greater number of lymph node sections than is possible by manual evaluation, thus improving the feasibility of this type of testing and increasing the likelihood of detecting any metastases that may be present. The ACIS system is designed to assist the pathologist by detecting, counting, and classifying cells of clinical interest based on the recognition of color, size, and shape.
Sentinel lymph node analysis, in which the first one to three lymph nodes to receive drainage from the breast are tested for the presence of metastatic cancer cells, is becoming increasingly popular. This analysis provides an alternative to the traditional method of removing 20 to 30 lymph nodes from the armpit. Up to 80% of women who undergo the more extensive surgery experience mild to severe complications ranging from chronic pain to lymphedema.
New Level of Sensitivity
"The ability of the ACIS to rapidly and accurately detect rare tumor cells brings a new level of sensitivity to lymph node analysis," said principal investigator Kenneth J. Bloom, MD, assistant professor of pathology, and director of laboratory operations at Rush Presbyterian-St. Luke’s Medical Center in Chicago. "By using ACIS, physicians can more thoroughly analyze sentinel nodes than is practical manually, and more accurately assess the true stage or spread of a patient’s disease. In our laboratory at Rush, we use the ACIS system not only in our research studies, but in the clinical testing of a variety of breast cancer markers."
A 70-year-old man with a history of localized prostate cancer treated with whole-pelvis radiation therapy with a boost to the prostate, in conjunction with androgen deprivation therapy 7 years prior, presented with lower back pain. A bone scan revealed an area of activity in the sacrum. What is the most likely diagnosis?
