By Kay Quinn, Special to the St. Louis Post-Dispatch, August 6, 2007

Getting a diagnosis of breast cancer is devastating for most patients. Cortney Nelson of Okawville is a married mother of two who works full time. She was diagnosed with breast cancer in May at age 29.

"It was very devastating in the very beginning," Nelson said. "Right now, I''ve coped with it quite well."

Nelson is one of a growing number of newly diagnosed patients to benefit from advances in technology that can tell her more about her cancer, faster than ever.

"Certainly that''s a big benefit not only to us as their physicians, but also to the patients from an emotional and psychological standpoint as well," said Dr. Julie Margenthaler, a breast surgeon at the Siteman Cancer Center in St. Louis.

One of the most important questions newly diagnosed patients have is whether their disease is localized to their breast or has begun to spread through the lymph nodes. Lymph nodes are part of the immune system responsible for filtering bacteria and even cancer cells. Patients with cancer cells in their lymph nodes are typically diagnosed with a more advanced stage of breast cancer requiring more aggressive treatment.

"About 15 years ago, researchers identified a way to locate the lymph node that we refer to as the sentinel lymph node," Margenthaler explained. "What that means is that it''s the first that would receive cancer cells if it were to spread to the lymph nodes."

Sentinel lymph node biopsy is now routinely performed, often when a woman has a lumpectomy or mastectomy to remove the original cancer mass. But because testing the lymph nodes is sometime performed in the latter stages of a breast cancer diagnosis, it can also leave important details up in the air. For example, a patient may not find out she or he needs chemotherapy until weeks after the initial diagnosis.

Now, molecular technology is allowing surgeons to check lymph nodes for cancer often the same day they perform a biopsy. Results are typically available a few days after the test is run.

In fact, Margenthaler is taking the concept a step further. She''s conducting a research trial to see whether sampling cells from lymph nodes through a simple needle biopsy can give doctors the same important information.

"This is really going to get us to a point where, when a patient comes to our office, we can give them all of the information immediately," Margenthaler said.

Nelson enrolled in Margenthaler''s study and had a needle biopsy done on her lymph nodes the same day as the biopsy on her breast lump.

The tests revealed cancer cells in both.

"They said it was a very aggressive disease and that they wanted to get on top of it as soon as they can," Nelson recalled.

Based on the tests, she was also advised to undergo six rounds of chemotherapy followed by surgery to remove any remaining cancer cells at the tumor site.

She''s now halfway through her chemotherapy treatments.

"I felt like they were really on top of things, that things were moving very quickly, and that I was glad that I didn''t have to wait weeks at a time, months at a time before I could get this started," Nelson said.