• Lymph nodes and blood

    Asked by Sparkplug on Saturday, February 9, 2019

    Lymph nodes and blood

    If doctors found cancer in lymph nodes and blood vessels, does that mean the cancer has metastasized?

    7 Answers from the Community

    7 answers
    • ChicagoSandy's Avatar

      po18guy, the link you posted confirms that "targeted" (aka biologic) therapies are only for HER2+ breast cancers--and not necessarily only metastatic ones. (Your error is understandable, as "breast cancer" is not one single cancer but a constellation of different cellular types of cancer, with lots of permutations & combinations when it comes to sites of origin--e.g., lobes vs. ducts--receptors and aggressiveness).

      Breast cancer is not considered "metastatic" until evidence is found of spread of the same type of breast cancer to distant organs: most commonly--depending on type of breast cancer--bone, liver, brain, lungs. Tumors that have had cells migrate to lymph nodes have an increased chance to become metastatic, but until they show up in distant organs they are not yet metastatic. (Even Stage IIIA is sometimes called "early").

      8 months ago
    • po18guy's Avatar

      Good to know. As with so many other cancers, sadly there are many varieties. I enjoy being right, but I learn when I am wrong. I will have to read up a bit. As I understood it, the normal way that cancer would metastasize is via blood or lymph - other than direct tissue invasion such as anaplastic thyroid cancer.

      8 months ago
    • ChicagoSandy's Avatar

      That is correct: breast cancer spreads via either the lymph nodes or bloodstream. "Luminal A," the least aggressive subtype (Grade 1 or 2, low mitotic rate, estrogen/progesterone-receptor+ and HER2-), almost always recurs given enough time (often, decades) if the patient doesn't die first of other causes, because its micromets usually "seed" and lie dormant long before a tumor can be diagnosed, and evolve to be able to synthesize their own estrogen supply--"outwitting" years of estrogen-depleting therapy.

      Those micromets can be so subtle that "sentinel" lymph nodes can nonetheless test "clear" at biopsy performed during lumpectomy or mastectomy surgery.

      8 months ago

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