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:10/13/2017)... ... ... The Visiting Nurse Association (VNA) of Somerset Hills is proud to host ... items from across the nation, this holiday-themed event will raise funds and awareness for ... The boutique will be open Saturday, November 4 (10:00 a.m. – 5:00 p.m.) ...
(Date:10/13/2017)... ... October 13, 2017 , ... Talented host, ... lowdown on sciatica in a new episode of "Success Files," which is an ... and innovation and investigates each subject in-depth with passion and integrity. , Sciatica ...
(Date:10/12/2017)... ... 12, 2017 , ... First Healthcare Compliance (FHC), an industry ... a range of technology and learning solutions at the 68th Annual American Healthcare ... be held October 14–18, 2017 at the Mandalay Bay Resort in Las Vegas, ...
(Date:10/12/2017)... CITY, Fla. (PRWEB) , ... October 12, 2017 , ... ... cold therapy products, announced today the introduction of an innovative new design of the ... multipurpose pad so you get maximum comfort while controlling your pain while using cold ...
(Date:10/12/2017)... ... October 12, 2017 , ... ... has recently contributed a medical article to the newly revamped Cosmetic Town ... article spotlights the hair transplant procedure known as Follicular Unit Extraction ...
Breaking Medicine News(10 mins):
(Date:10/12/2017)... , Oct. 12, 2017 AVACEN Medical , ... company with their  2017 New Product Innovation Award for ... extensive primary and secondary medical device market research by Frost ... its first-to-market OTC, drug-free pain relief product, the AVACEN 100, ... to treating fibromyalgia widespread pain. ...
(Date:10/11/2017)... Texas , Oct. 11, 2017  True ... services, has amplified its effort during National Breast ... about hereditary cancer risks. ... of Clinical Oncology calculated that more than 10 ... have inherited mutations in BRCA1 or BRCA2 and have ...
(Date:10/5/2017)... , Oct. 5, 2017  In response ... of Oral and Maxillofacial Surgeons (AAOMS) released prescribing ... – to be used as a first-line therapy ... Recognizing the ... AAOMS White Paper "Opioid Prescribing: Acute and Postoperative ...
Breaking Medicine Technology: