'Micro' Spreading of Breast Cancer Needs Treating, Study Urges

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The new study "doesn't change the standard of care for node-positive disease, even when there is microscopic disease," noted Dr. Rick Bleicher, a breast surgeon at Fox Chase Cancer Center in Philadelphia. "It reinforces the standard of care, which is axillary dissection," meaning the removal of affected nodes nearest the breast, he said.

But in cancer treatment, there may be such a thing as too much intervention as well, which the new lung cancer study suggests.

Researchers from the U.S. National Institutes of Health concluded that the use of low-dose CT as a screening tool for lung cancer results in many false-positives -- a full 33 percent after two screenings. And that, they said, makes an already unclear benefit seem simply not worth the downside, in terms of patient anxiety and expense.

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"We'd seen some increasing promotion of low-dose CT scans as a screening tool, mostly individual hospitals, some direct-to-consumer advertising, some suggesting that the value of these scans can alleviate anxiety," said Dr. Jennifer M. Croswell, acting director of the NIH Office of Medical Applications of Research. "But there was no good evidence that if you get screened you actually have fewer deaths. The potential burdens of screening are underexamined."

Finding such a high false-positive rate in the pilot trial -- part of a larger lung-cancer screening trial of former and current smokers -- means that "we need continued investigation before continued promotion to the public," she continued.

Another expert agreed. "We need to wait for the [full] results of the national lung screening trial so we can figure out if there is a survival benefit and, if there is and it's powerful, we'll accept the false-positives," said Dr. Julie Gralow, an associate professor of oncology at the University of Washington who moderated a news conference to report the findings.

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