Understanding how breast cancer changes the lymph node chain to help spread around the body

Breasts contain a network of thin tubes connected to the lymph nodes. These lymph nodes can help patients with breast cancer. They can launch a powerful immune response against cancer. But sometimes they can also help the disease to spread to other parts of the body.

We need to understand what changes a lymph node from being helpful to harmful. By understanding this, we can identify which patients can safely avoid more extensive surgeries. We could also find ways to use the body’s own immune system to treat breast cancer.

Dr Amy Llewellyn is working with the team led by Dr Kalnisha Naidoo at King’s College London and Dr Sophie Acton at University College London. They’re studying aggressive oestrogen receptor-negative breast cancers that have spread to the lymph nodes.

Firstly, Amy is examining preserved lymph node samples from patients whose breast cancer didn’t respond well to chemotherapy given before surgery. She’ll assess how the various cell types within the lymph nodes change when cancer develops and replaces healthy tissue.

She’s also using a unique system that allows researchers to keep patient lymph nodes "alive" outside the body. Amy will use it to study the flow of lymph fluid through the lymph node chain. She’ll connect a lymph node that contains breast cancer to a healthy lymph node. This will allow her to study these lymph nodes and the proteins they use to communicate.

Lastly, Amy will investigate this further in mice. She’ll look at whether fluid samples from affected lymph nodes can lead to changes inside the healthy lymph nodes in mice. This work will focus on cells which make up the backbone of the lymph node. The researchers suspect that these cells may control how the lymph nodes change in response to breast cancer.

This study will improve our understanding of how treatment-resistant breast cancer spreads through the lymph nodes in the armpit.

Researchers hope this work will help to reduce the number of patients who need surgery to remove lymph nodes in the armpit. It could spare people from experiencing side effects from this additional surgery. This project could also help to develop targeted treatments to stop breast cancer spreading.

Around 11,000 or 1 in 5 women are diagnosed with ER-negative breast cancer every year in the UK. This project is aiming to improve breast cancer treatment and could help the thousands of women who currently go on to develop incurable secondary breast cancer.