Navigation Links
Removing Many Lymph Nodes in Early Breast Cancer Not Always Needed: Study
Date:2/9/2011

By Amanda Gardner
HealthDay Reporter

TUESDAY, Feb. 8 (HealthDay News) -- Removing many lymph nodes may not be necessary in women with early breast cancer who also undergo a lumpectomy to remove the mass, followed by radiation.

Researchers reporting in the Feb. 9 issue of the Journal of the American Medical Association found that just removing one or two sentinel nodes -- those lymph nodes to which the cancer spreads first -- allows women to live just as long as women who have more lymph nodes removed from under their arm.

But it's unclear at this point whether this could be practice-changing.

"If you're looking at a woman with a very limited amount of disease in the sentinel node and with a very limited amount of disease undergoing breast conservation surgery [lumpectomy], it may suggest that they can potentially avoid axillary dissection [removing most or all of the lymph nodes under the arm] . . . but that's being said with a lot of caution," noted Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, who was not involved with the study. "[But] we can't say that they absolutely can."

Another expert was more emphatic.

"This is an important study," said Dr. Jay Brooks, chairman of hematology and oncology at Ochsner Health System in Baton Rouge, La. "It's the largest randomized trial showing that women with positive sentinel nodes do not necessarily need to have further axillary [underarm] sampling when treated with radiation and/or chemo. This will reduce complications, and will change the way doctors approach patients."

Among other things, removal of lymph nodes can result in a painful and debilitating condition called lymphedema, or swelling, because lymph fluids can no longer travel freely through the body.

The standard of care in breast cancer is still debated but generally, said Bernik, "If you have a positive lymph node, the standard generally is to use axillary dissection unless [cancer involvement] is thought to be minimal in the lymph node."

These researchers, from the John Wayne Cancer Institute at Saint John's Health Center in Santa Monica, Calif., wanted to see if they could avoid axillary dissection without compromising survival.

After undergoing lumpectomy to remove the tumor, followed by radiation and chemotherapy, women with evidence of cancer in one or two sentinel nodes were randomized to undergo axillary node dissection of 10 nodes or, alternatively, to forgo any further treatment.

The study involved about 1,000 women, only half of the 2,000 the researchers had set out to enroll.

In those having axillary node dissection, the median number of nodes removed was 17, vs. two with sentinel only.

But there didn't seem to be any differences with survival, with more than 92 percent in both groups still alive after five years, indicating to the authors that sentinel node biopsy might be not only less invasive, with fewer side effects, but also effective.

But the report is unlikely to quell an ongoing controversy surrounding lymph node removal, Bernik said. In fact, she noted, it may even add to it.

The women in the study were not necessarily representative of all women with breast cancer, and generally had less cancer in their lymph nodes: Those with cancer that had progressed further were unlikely to be willing to be randomized into one of the two groups, she said.

"People have to understand that we're looking not at all women undergoing sentinel node biopsy. We're looking at a select group," Bernik said. "Some people are going to say that based on this data, we can avoid axillary dissection, and I think it's probably too premature to say that."

More information

The U.S. National Cancer Institute has more on sentinel lymph node biopsy.

SOURCES: Stephanie Bernik, M.D., chief, surgical oncology, Lenox Hill Hospital, New York City; Jay Brooks, M.D., chairman, hematology and oncology, Ochsner Health System, Baton Rouge, La.; Feb. 9, 2011 Journal of the American Medical Association


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Removing Gallbladder Sooner Cuts Costs, Readmissions
2. Removing 2mm around breast cancer tumors prevents residual disease in 98 percent of patients
3. New Finding Suggests Safe Surgical Margins When Removing Breast Cancers
4. Sleep Study May Be Advisable Before Removing Tonsils, Adenoids
5. Tumors hide out from the immune system by mimicking lymph nodes
6. Specific lymph node radiotherapy is well tolerated after surgery in early breast cancer patients
7. New class of drug kills lymphoma cells
8. Routine breast cancer biopsy might predict lymph node cancer spread
9. Vitamin K may protect against developing non-Hodgkins lymphoma, say Mayo Clinic researchers
10. The Cancer Help Store Debuts New Blog with Information About Lymphedema and Cancer
11. Scott & White Healthcare clinical trials target lymphoma, leukemia
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Removing Many Lymph Nodes in Early Breast Cancer Not Always Needed: Study
(Date:6/24/2017)... ... June 24, 2017 , ... ... Located at 217 Portion Road in Lake Ronkonkoma, Dental365 offers patients high-quality and ... so that visits to the dentist fit into their patients’ busy lifestyles. Dental365 ...
(Date:6/23/2017)... ... June 23, 2017 , ... ... the launch of Care Management Alerts and Dashboards, an innovative new service enabling ... Island. , RIQI’s Care Management Alerts and Dashboards provide near real-time data about ...
(Date:6/23/2017)... ... 2017 , ... Yesterday, U.S. Senate Republicans revealed details of ... replace the Affordable Care Act (ACA). Like the bill narrowly passed by the ... public health insurance program for low-income children, pregnant women, parents of dependent children, ...
(Date:6/23/2017)... ... 2017 , ... Dr. Ran Y. Rubinstein , a ... offering three new minimally invasive procedures to patients who want a younger and ... Rubinstein is excited to bring microneedling, microneedling facials, and platelet rich plasma (PRP) ...
(Date:6/23/2017)... ... ... Goodcents Deli Fresh Subs today announced the opening of a new restaurant in ... Kan. 66604 (near 21st and Gage). It is owned and operated by long-time Goodcents ... the Topeka and Bonner Springs, Kan. area. , “Goodcents has such a loyal ...
Breaking Medicine News(10 mins):
(Date:6/8/2017)... Fla. , June 8, 2017  Less than ... that hit more than 200,000 companies, including hospital networks, ... being heralded as one of the largest online extortion ... in the healthcare market, it is imperative that providers ... protect their data from this — and many other ...
(Date:6/7/2017)... 2017  Diplomat Specialty Infusion Group, a brand of Diplomat Pharmacy, ... Iowa location. The ... features an ISO 7 cleanroom—the standard needed to compound intravenous (IV) ... level of pollutants. "Our new ... better serve our Iowa patients," said ...
(Date:6/1/2017)... BLUE BELL, Pa. , June 1, 2017 /PRNewswire/ ... Nutriceuticals (PRN) and Veterinarian Recommended Solutions (VRS), and KD ... direct investment in Nutriceutical Holdings by KD Pharma Group. ... Nutriceutical Holdings with the option to acquire the entire ... ideal partner in KD. They are committed to growing ...
Breaking Medicine Technology: