Early breast-cancer cases may not need extensive lymph node removal
Breast cancer surgery traditionally includes removal of lymph nodes near the tumor so that doctors can check for signs that the cancer has spread. However, people with early-stage breast cancer that has spread to a nearby lymph node may not need to have additional lymph nodes removed.
In a study published Tuesday in the Journal of the American Medical Assn., researchers examined patients who had an early-stage tumor. All of the patients had their tumors removed with lumpectomy (when just part of the breast is removed, not the entire breast) and then had radiation therapy. Most of the women also had chemotherapy. All the women also had evidence of cancer in the sentinel lymph nodes -- the one or two nodes closest to the tumor. In about half of 891 women, however, doctors also removed at least 10 additional lymph nodes that were in the armpit, or axillary.
Cancer was found in the axillary lymph nodes in 27% of those women. Nevertheless, after an average of about six years, the study showed little difference in cancer recurrence or survival between the women who had many nodes removed and those who had only the sentinel nodes removed.
However, as expected, the patients who had axillary nodes removed had more complications from surgery, including infections and swelling. Swelling from excess fluid in the lymph tissue is called lymphedema and can persist long after recovery from the cancer, said the authors of the study, led by Dr. Armando E. Giuliano of the John Wayne Cancer Institute at St. John’s Health Center in Santa Monica.
The findings add to a collection of studies that “have shown that less surgery combined with more radiation and chemotherapy have improved survival for women with breast cancer,” said the authors of a commentary accompanying the study.
Related: Breast cancer patients’ quality of life returns slowly in the year after surgery
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