Breast Cancer Surgery & Lymph Nodes
A recent report indicates that removal of axillary lymph nodes may not improve breast cancer survival for some women. Data from this recently published study found that people with early-stage cancer that spreads to a nearby lymph node fared just as well after treatment without the removal of additional lymph nodes in the armpit area. This may be good news for patients.
Axillary Lymph Nodes & Breast Cancer Treatment
Breast cancer surgery often includes the removal of axillary lymph nodes (those in the armpit area) so doctors can check whether the cancer has spread. However, this procedure can cause swelling and stiffness in the arm, and in some extreme cases, lymphedema (fluid retention and tissue swelling due to a compromised lymphatic system).
It has long been the goal of breast surgeons to remove as few of these lymph nodes as clinically necessary. Lymph node status has been used to determine additional therapies for women diagnosed with cancer.
Study Results
The study examined more than 800 patients with early-stage tumors. All the patients had only part of their breast removed (lumpectomy). Additionally, these patients had radiation therapy and some had chemotherapy.
In about half of the women, doctors also removed at least 10 axillary lymph nodes. Cancer was found in the axillary lymph nodes in 27% of the women in the study.
The study found, however, that the five-year survival rate was 91.8% in the women with axillary-node removal, compared with 92.5% who did not have those nodes removed.
The findings add to a collection of studies that have shown that less surgery combined with more radiation and chemotherapy may improve survival for women with cancer. This further demonstrates that the type of surgical intervention has little impact on overall outcomes.
If you have questions about any procedure your doctor is recommending, be an informed consumer of medicine and don’t hesitate to bring these issues up. The more comfortable you are with talking to your doctor about your health, the better.
What It Means
As is the case with most new studies, it is important to realize that the findings may have application in selected patients, and needs further validation before it becomes the standard. The data has reported only five year outcomes, which is a relative short time frame, but, a great start. Before becoming the standard of care, physicians involved in breast care will use this information to determine the best possible treatment plan for individual patients.
Breast cancer care is multidisciplinary, and collaboration of cancer specialists, including surgical, medical, and radiation oncologists, is paramount in determining the best treatment plans.
The author was named a top breast cancer surgeons in the Greater Detroit area. He is certified in ultrasound breast biopsies by the ASBS, is a member of The American Society of Breast Surgeons and The American Society of Breast Disease, and has served on the Membership Committee of the American Society of Breast Disease since 2007. Dr. Brown practices at Comprehensive Breast Care.
