Lymph Node Removal Not Necessary for Breast Cancer Patients

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Aggressive lymph node removal may not be necessary for women with early-stage breast cancer.

Scientists say that women who had surgery on the node closest to the cancer - the sentinel lymph node - survived just as long as their counterparts who received more invasive lymph node removal in the armpit.

Axillary lymph node dissection usually follows a lumpectomy if the cancer has spread at all outside the breast. It has been in practice for nearly a century since doctors began performing radical mastectomy, or breast removal, UPI reports.

"The thought among many is that if you removed fewer than 10 lymph nodes that the treatment was inadequate," said Dr. JoAnne Zujewski, senior medical oncologist at the National Cancer Institute, according to ABC News. "It was a widely held belief that more aggressive therapy was better; the bigger the surgery the better the care."

But the study suggests that limiting the procedure doesn't mean poorer survival rates. Between May 1999 and December 2004, breast cancer doctors at 115 hospitals reviewed nearly 900 women with early stage tumor invasive breast cancer, no enlarged lymph nodes and one or two sentinel lymph nodes that contained cancer spread. They found that rates of survival and of remaining cancer-free were just as good whether the women had extensive surgery for lymph node removal or skipped the procedure.

The trial, led by Dr. Armando E. Giuliano of the John Wayne Cancer Institute at Saint John's Health Center in Santa Monica, Calif., was conducted from May 1999 to December 2004. 445 patients were randomly assigned to the group that received aggressive lymph node surgery, and 446 underwent no further surgery.The women simultaneously underwent whole-breast radiation and some type of chemotherapy or hormone-blocking treatment.Five years after the surgery, approximately 92 percent of the women in both groups were still alive. 84 percent of the women who received only sentinel node dissection were cancer-free, compared to 82 percent in the axillary node dissection group.The findings suggest that more aggressive cancer treatment is not necessarily more effective - a significant development, especially since axillary lymph node surgery causes debilitating arm swelling, stiffness and pain. It also carries risk of serious complication and infection.The study was published in the Journal of the American Medical Association.Women 40 and older should have a mammogram every 1-2 years to raise chances of early detection, and should make sure to get a thorough breast exam by a medical provider every year. If you notice any change in your breasts - including lumps, distortions, or swelling - don't hesitate to call your doctor immediately.
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