Changes in lymph nodes may help show which breast cancer patients face higher or lower risk of the disease spreading, researchers have found.

The findings could support more tailored care, new treatments and help more people avoid unnecessary treatment.

Dr Simon Vincent is chief scientific officer at Breast Cancer Now, which funded the research:

He said: “These findings suggest that changes to the structure of the lymph nodes are more than just a consequence of the cancer. They can also play an active role in helping breast cancer progress.

“With one person tragically dying from breast cancer every 45 minutes in the UK, we urgently need research like this so that we can better understand who is most at risk of their cancer progressing and becoming incurable. Only then we can find ways to stop it.

“With a better understanding of how lymph nodes change as breast cancer spreads, we could find new targets for future treatments for types of breast cancer that are harder to treat.”

Lymph nodes, a key part of the immune system, help the body fight infections and cancer. In breast cancer, the lymph nodes in the armpit are often the first place the disease spreads to.

At the moment, everyone with invasive breast cancer has to undergo surgery to remove lymph nodes so doctors can check for cancer cells.

Invasive breast cancer means cancer that has spread beyond where it first developed in the breast into nearby tissue.

While this is effective, it can lead to long-term side effects such as swelling of the arm, known as lymphoedema, and may be unnecessary for some patients, particularly those with early-stage disease or those whose cancer responds well to treatment.

The study analysed 331 lymph node samples from people with different types of breast cancer and compared them with healthy lymph nodes from people free from the disease.

It found that breast cancer could change the structure of a network that supports the lymph nodes.

Crucially, some of these changes could occur before doctors were able to spot any cancer cells in the network.

Some changes were linked to a better chance of survival, while others were associated with a poorer prognosis.

Dr Amy Llewellyn and Dr Kalnisha Naidoo from King’s College London, together with professor Sophie Acton at University College London, compared the 331 samples with healthy lymph nodes in people free from the disease.

They looked at fibroblastic reticular cells, known as FRCs, a group of cells in lymph nodes that provide their structure, control fluid flow and activate different immune cells.

The study showed that the structure of this FRC network could change before the cancer had spread and differed depending on the type of breast cancer, any spread and whether someone had received chemotherapy.

Chemotherapy uses medicines to kill cancer cells or slow their growth.

The researchers said the findings could help doctors better understand who is most at risk of breast cancer spreading.

Dr Llewellyn said the first large-scale analysis of FRC in human lymph node tissue from breast cancer patients was addressing the “urgent need” for a better understanding of the area’s biology.

A new free menopause toolkit has been launched to help UK employers respond better to menopause at work, improve wellbeing and retain experienced staff.

Wellbeing of Women has launched MENO-Kit in partnership with Lancaster University, which it describes as the UK’s first evidence-based menopause workplace toolkit.

The online resource translates more than a decade of academic research into practical guidance for employers.

It is designed for managers, human resources and occupational health teams, equality, diversity and inclusion leads, trade unions and employees.

Its four modules cover menopause awareness, symptom management, menopause champion training and cognitive behavioural strategies.

These are techniques that help people spot and change thought or behaviour patterns that can make symptoms harder to manage.

Amanda Griffiths, emeritus professor of occupational health psychology at the University of Nottingham, said: “I am so pleased the Wellbeing of Women’s toolkit is now available.

“It presents the culmination of many years’ research by Claire Hardy, Myra Hunter and myself at our three universities.

“It’s a clear story: women represent nearly half the working population and menopause is a normal event in their lives.

“Those who experience difficulties appreciate understanding and support. And it’s not difficult to provide.

“I really hope that the next generation of working women, their colleagues and their managers will find the toolkit helpful.”

MENO-Kit was informed by research studies conducted by Lancaster University, the University of Nottingham and King’s College London.

This included the UK’s first large-scale study of women’s experience of menopause at work, carried out at the University of Nottingham, which identified fatigue, poor concentration, low mood and hot flushes as symptoms affecting working life.

It also highlighted the kinds of employer support working women said they would find helpful.

The toolkit has been tested in eight UK organisations across the public, private and charity sectors.

A total of 2,162 people, mostly women in their mid-40s and 50s, contributed across the studies.

The launch comes at a time of growing urgency for employers.

Research from McKinsey & Company highlights the economic opportunity of closing the women’s health gap, estimating it could unlock up to £11bn a year for the UK economy.

The NHS Confederation has also highlighted the economic case for investing in women’s health, linking better support to improved workforce retention and reduced pressure on employers and public services.

Alongside this, research has continued to show the impact of menopause at work.

Separate polling by Benenden Health found that 28 per cent of women had considered leaving work because of symptoms, while 31 per cent reported reduced productivity.

MENO-Kit has been developed to help organisations respond with practical, evidence-based tools that build confidence, reduce stigma, improve wellbeing and help retain experienced staff.

The launch is being marked by an online event featuring a keynote from the Rt Hon Dame Diana Johnson, minister of state for employment, a live demonstration of MENO-Kit by Dr Abigail Morris, and a discussion on practical approaches to creating menopause-supportive workplaces.

Janet Lindsay, chief executive at Wellbeing of Women, said: “Too many women still struggle in silence during menopause at work, with many employers lacking the tools to respond effectively.

“MENO-Kit addresses this gap, offering practical, evidence-based ways for organisations to better support their people.

“It helps women stay working, thrive, and realise their potential at work.

“We’re hugely grateful to the research teams whose expertise has made this possible.”

Dr Abigail Morris, lecturer in workplace health and wellbeing at Lancaster University, said: “We’re delighted to launch Meno-Kit which represents an important step forward in supporting organisations across the UK to take a proactive and informed approach to menopause in the workplace.

“By providing practical tools, evidence-based guidance and a structured framework for action, the resource will help organisations develop effective menopause action plans, foster more inclusive and supportive workplace cultures, and better support women experiencing menopause to remain healthy, engaged and thriving at work.

“We believe Meno-Kit has the potential to drive meaningful organisational change while improving the everyday working lives and wellbeing of women across the UK workforce.”

Davina McCall, Wellbeing of Women ambassador, said: “Menopause shouldn’t be something women hide or struggle with alone at work or anywhere.

“It’s a normal life stage, not a personal failing.

“By talking about menopause openly and putting the right support in place, workplaces can make a huge difference to women’s wellbeing, confidence and careers enabling them to thrive at work.”

Elation Health has acquired Aster, a women’s health EHR startup created by sisters Fifi Kara and Dr Lailah Kara-Newton.

The deal, announced on 3 June 2026, will see Aster’s team join Elation Health as the company expands development of what it describes as the first agentic operating system for primary care.

An EHR, or electronic health record, is a digital system used by healthcare providers to store and manage patient information.

Aster was founded by Kara and Kara-Newton as an AI-native EHR platform for women’s health providers.

Elation Health said the acquisition would allow Aster to learn from its expertise in AI agents and support development of its agentic operating system for primary care.

Kyna Fong, co-founder and chief executive of Elation Health, said: “The Aster team impressed us with their vision and creative inventions to support independent practices.”

Fong said Elation, like Aster, was founded by siblings who wanted to change the healthcare system.

She added: “That shared north star means they understand what we’re building and why it matters. It was clear right away they would significantly add to our capabilities.”

Kara has spent 10 years creating consumer and business-to-business products across the UK, Europe and the US, and recently supported Meta’s Health & Fitness team, according to Aster’s website.

Kara-Newton previously worked as a hospital doctor in the NHS across medical and surgical specialties, including breast surgery, general surgery, emergency medicine and obstetrics and gynaecology.

Aster launched in 2023 after raising US$2.8m from Zeal Capital Partners, Cornerstone Ventures, Octopus Ventures and others.

Kara, Kara-Newton and Aster’s chief technology officer, Nacho Vazquez, will all join Elation.

Kara said: “From the moment we met Kyna Fong, Ashley Rogers, and the Elation leadership team, it was clear we were aligned on what matters most: that clinicians deserve truly incredible software that brings joy back to their practice. Together, we can now bring that vision to millions of primary care patients across the country.”

The sisters said their work was shaped by Kara-Newton’s first pregnancy, when undiagnosed pre-eclampsia led to an emergency caesarean section and neonatal intensive care admission for her son.

The founders said they wanted to build technology that could help prevent similar outcomes for other women.

The acquisition comes amid continued concern over maternal health inequalities in the US.

In the US, Black maternal mortality remains alarmingly high, with rates nearly double those of white women, and experts point to unequal access to care, implicit bias and fragmented approaches to care.