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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 gene
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