MICRO VS NANOMETASTISIS

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agada
agada Member Posts: 452
edited June 2014 in DCIS (Ductal Carcinoma In Situ)

Hello

Is there a difference between micro and nanometastisis? If now what is the difference?  This is a confusing difference in diagnosis to me.  Thanks.

Agada

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  • Emaline
    Emaline Member Posts: 492
    edited May 2011

    I saw your question in mine, and I really don't know. When I google, all I am coming up with are studies, and I'm not really good at dissecting them.

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  • mks16
    mks16 Member Posts: 415
    edited May 2011

    agada, nanometastases are clusters of isolated tumour cells, also referred to as submicrometastases (largest diameter < 0.2 mm) and aren't really considered metastases, according to most studies they can be safely ignored.

    Edited to add: you will find more detailed information if you google them as isolated tumour cells.

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  • ScienceGirl
    ScienceGirl Member Posts: 207
    edited May 2011

    I've briefly looked at a few papers.  

     "The use of SNB now saves many patients with early-stage breast cancer the unnecessary morbidities of an AND. At the same time, closer examination of the SN has generated the increased detection of positive nodes through the identification of isolated tumor cell metastases, pN0 (i+; known as nanometastases), and micrometastases (pN1mi)."   (2009 J. Clin. Onc) (AND= axillary node dissection; SNB= sentinel node biopsy)

    So, I think NANOmetastasis are isolated tumor cells (usually <200 cells I think) and MICROmetastasis is a group of >200 cells.

    I have seen some places where they use these terms interchangeably - I think in older references.  You can have nanometastasis in the SN and still be considered node negative (this is what I am).   My ONC says that the thinking now is that the few cells found in sentinel nodes were "knocked loose" during surgery.

    Hope this helps

    Kim

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited May 2011

    I am a somewhat unusual case but wanted to throw this in.  I had BMX with SNB and path in the OR was neg on the SN.  Post-op path showed a 20 cell cluster (which was termed micrometastasis) so I ended up with AND.  I had one additional positive node of 11 removed but it had a 6mm area, so larger than the SN.  While I really didn't want to have the AND, and argued against it, my BS and onc both wanted it and that 6 mm node would have been left there if the loose cell assumption was used in reference to the SN. Because I had a BMX no rads were planned but I am currently in chemo and I am glad that the additional node was removed instead of relying on chemo to take care of it.  

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  • agada
    agada Member Posts: 452
    edited May 2011

    Good Morning

    Thank you for the clarifications.  I will google isolated tumour cells in pn0(i+) lymph nodes for 2010 papers.  I still cannot see how a nanometastisis is considered node negative....except for the surgery explanation.  In other words, the docs just don't know yet.  Its the yet that makes me nervous.  Once again thank you for your help.

    Agada

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  • Chocolaterocks
    Chocolaterocks Member Posts: 364
    edited May 2011

    agada

    check out my posts on isolated tumor cells and the fact that I heard the following:

    from the excisional biopsy so its nothing

    too - we can tami if you want to

    too- you need to be on tami for 5 years and then something else...

     Would love assistance on this since node negative with nothing to worry about it- would of been great- oh well

    hope to hear from you AND still others!!!

    chocolate

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  • agada
    agada Member Posts: 452
    edited May 2011

    Ilovechocolate,

    My doc will not give me tami as he said it is overkill in this kind of situation.  So, I will worry like an idiot.  My doc said the side effects of tami or anyother treatment are worse than what I have. Go figure.

    Agada

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  • Chocolaterocks
    Chocolaterocks Member Posts: 364
    edited May 2011

    I wish they would of done that for me!!! With stage 0, less than 1 cm- it sounds really good.

    thanks for the post.

    Regarding the worry- that is challenging. 

    take care.

    chocolate

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