[Lani]

Before it was just a "judgement/guess" that perhaps breast cancer behaved differently than many other cancers because cutting it out and radiating it did not cure as many people as other cancers.

Now we have the technology to discover if that is true, machines to test for circulating tumor cells and better techniques to look for individual cells in bone marrow samples--yet those aren't hardly being used.

Here they showed in mice that they could see disssemination of tumor cells even from DCIS when her2 was present. To me, that means looking for signs of micrometasis when staging the breast cancer would make sense.

Also, many drugs languish for years being used for those with macrometastasis only, which could be tried at an earlier stage with the understanding if micrometastasis were looked for and found to see if that would impact the disease. That is just beginning with trials of herceptin with avastin in the adjuvant setting, but perhaps highrisk patients should no longer be defined by the number of lymph nodes positive, but by whether there are isolated tumor cells in their bone marrow.

I don't want to annoy people who will say, yes, but I could never get my oncologist to look for that, only to make people aware that evidence has been found for what oncologist only suspected and perhaps this knowledge should be used to look freshly upon how cancer is staged, clinical trials run and patients treated