Navigation Links
Limited lymph node removal for certain breast cancer does not appear to result in poorer survival
Date:2/8/2011

CHICAGO Among patients with early-stage breast cancer that had spread to a nearby lymph node and who received treatment that included lumpectomy and radiation therapy, women who just had the sentinel lymph node removed (the first lymph node to which cancer is likely to spread from the primary tumor) did not have worse survival than women who had more extensive axillary lymph node dissection (surgery to remove lymph nodes found in the armpit), according to a study in the February 9 issue of JAMA.

Axillary lymph node dissection (ALND) has been part of breast cancer surgery since the use of radical mastectomy and reliably identifies nodal metastases. "Sentinel lymph node dissection (SLND) accurately identifies nodal metastasis of early breast cancer, but it is not clear whether further nodal dissection [removal] affects survival," the authors write. "ALND, as a means for achieving local disease control, carries an indisputable and often unacceptable risk of complications such as seroma [a mass or swelling caused by the localized accumulation of serum within a tissue or organ], infection, and lymphedema [condition in which excess fluid called lymph collects in tissues and causes swelling]."

Armando E. Giuliano, M.D., of the John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, Calif., and colleagues conducted a study to determine the effects of ALND on overall survival in patients with SLN metastases treated with lumpectomy (surgical removal of a tumor without removing much of the surrounding tissue or lymph nodes) and radiation therapy. The trial was conducted at 115 sites and enrolled patients from May 1999 to December 2004. Patients were women with T1-T2 (stage of tumor) invasive breast cancer, no palpable adenopathy (enlarged lymph nodes), and 1 to 2 SLNs containing metastases.

Patients with SLN metastases identified by SLND were randomized to undergo ALND or no further axillary treatment. Those randomized to ALND underwent dissection of 10 or more nodes. Of 891 patients, 445 were randomly assigned to the ALND group and 446 to the SLND-alone group.

As expected, there was a difference between ALND and SLND-alone treatment groups in total number of removed lymph nodes and total number of tumor-involved nodes; the median (midpoint) total number of nodes removed was 17 in the ALND group and 2 in the SLND-alone group. At a median follow-up of 6.3 years, there were 94 deaths (SLND-alone group, 42; ALND group, 52). The use of SLND alone compared with ALND did not appear to result in statistically inferior survival, with the 5-year over all survival rates being 92.5 percent in the SLND-alone group and 91.8 percent in the ALND group. Disease-free survival did not differ significantly between treatment groups, with 5-year disease-free survival being 83.9 percent for the SLND-alone group and 82.2 percent for the ALND group.

The rate of wound infections, axillary seromas, and paresthesias (prickly, tingling sensations) among patients in the trial was higher for the ALND group than for the SLND-alone group (70 percent vs. 25 percent).

The authors note that these results suggest that breast cancer patients, such as those in this study, do not benefit from the addition of ALND in terms of local control, disease-free survival, or overall survival, and that ALND may no longer be justified for certain patients. "Implementation of this practice change would improve clinical outcomes in thousands of women each year by reducing the complications associated with ALND and improving quality of life with no diminution in survival."


'/>"/>

Contact: Greg Harrison
gregory.harrison@stjohns.org
310-829-8010
JAMA and Archives Journals
Source:Eurekalert

Related medicine news :

1. Tests to Measure Safety of Anti-Clotting Drugs of Limited Value
2. QB3 Adds Zcube As Limited Partner In Mission Bay Capital Fund
3. Preventive behaviors limited household transmission of H1N1 influenza during initial outbreak
4. Irelands Allergy Standards Limited Adds LG Electronics to Host of Companies Making Allergy-Certified Consumer Products
5. Healthy food makes consumers feel hungrier when choices are limited
6. Serendipity House Limited, the Leading Provider of Natural and Organic Products in Hong Kong, Renews Multi-year Relationship with Seventh Generation
7. Hispanics live in areas with limited capacity for colorectal cancer screening
8. Reflex Stock Limited Announces Two New Ways to Buy Stock Images and Stock Photos
9. New Menopause Supplement – Estrofil from BIOTX Limited – Offers All-Natural Relief from Menopausal Symptoms and Money-Back Guarantee
10. pzizz Technology Limited Releases New “Lite” Version of the pzizz Sleep App
11. Circumcising gay men would have limited impact on preventing HIV
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/8/2016)... ... December 08, 2016 , ... STAT courier is pleased ... a convenient service for Texas, they are expanding their presence in Dallas. One of ... spree that will bring new jobs to the Dallas and Forth Worth market. STAT ...
(Date:12/8/2016)... ... December 08, 2016 , ... Vida Health, the digital ... B led by Canvas Ventures . Other investors include Nokia Growth Partners (NGP) ... platform to serve more consumers who are managing chronic conditions or simply ...
(Date:12/8/2016)... ... December 08, 2016 , ... Peter Zipp ... in and around the greater Phoenix metropolitan region, is announcing a charity event ... mission of the Homeless Youth Connection is to promote community awareness of the ...
(Date:12/8/2016)... ... December 08, 2016 , ... ... families and business owners in and around central Kansas, is joining the Youth ... youth in the region. , Headquartered in Wichita, Youth Horizons works to empower ...
(Date:12/7/2016)... ... December 07, 2016 , ... Kenall Manufacturing, a leader ... MedMaster™ MPCNGX . The MPCNGX is a multi-function, sealed, LED luminaire that meets the ... light where and when it’s needed. , A 2’ x 4’ model ...
Breaking Medicine News(10 mins):
(Date:12/8/2016)... , December 8, 2016 According to a new ... BP, Sleep, Fetal), Therapeutic (Pain, Insulin)), End Use (Sports, Fitness, RPM), Type ... by MarketsandMarkets, the global market, in terms of value, is projected to ... a CAGR of 18.0% during the forecast period. ... ...
(Date:12/8/2016)... Mass. , Dec. 8, 2016  Haemonetics Corporation (NYSE: ... NextGen DMS (Donor Management System), an innovative software suite designed ... The launch of NextGen DMS 4 improves ... including: reducing the cost per liter of plasma collected, enhancing ... improve plasma center operations. ...
(Date:12/8/2016)... BEIJING , and SAN DIEGO , ... genomic services and solutions with cutting edge next-generation sequencing and ... biotechnology company; and the Genome Institute of ... (NovogeneAIT) – a new joint venture between Novogene and AITbiotech ... at Biopolis, Singapore .   ...
Breaking Medicine Technology: