Lymph Node Metastases Appear Associated With Stem Cell Mutations in Breast Cancer

Tumors in which breast cancer stem and progenitor cells (BCSCs) have defects in PI3K/Akt (a pathway that is part of cell proliferation) signaling appeared to be associated with nodal metastases in a study by Cory A. Donovan, M.D., of the Oregon Health & Science University, in Portland, and colleagues.

In the study, malignant (BCSCs) and benign stem cells were collected from surgical specimens and tested for oncogene (which can cause cancer) mutations from 30 invasive ductal breast cancers (stages 1A through IIIB). Researchers looked for mutations in oncogenes AKTI, HRAS and PIK3CA and their correlation with tumor mutations, pathologic tumor stage, tumor hormone receptor status and lymph node metastases.

“Tumors in which BCSCs have defects in PI3K/Akt signaling are significantly more likely to manifest nodal metastases. These oncogenic defects may be missed by gross molecular testing of the tumor and are markers of more aggressive breast cancer. Molecular profiling of BCSCs may identify patients who would likely benefit from PI3K/Akt inhibitors, which are being tested in clinical trials,” the authors conclude.

(JAMA Surgery. Published online July 24, 2013. doi:10.1001/jamasurg.2013.3028.