Crouse Health Online: Wellness is just a click away.
  |  Connect with Us: 
Text Size

Health News

Study Questions Use of Less-Invasive Lymph Node Surgery for Breast Cancer

Study Questions Use of Less-Invasive Lymph Node Surgery for Breast Cancer


MONDAY, Oct. 7 (HealthDay News) -- A study that sought to see if a less-invasive, less-debilitating procedure could determine accurately how far breast cancer has spread fell short of the safety threshold the researchers set.

The procedure, common for women who receive chemotherapy before their tumor is removed, is known as sentinel lymph node surgery. During the procedure, doctors try to identify and remove only the lymph nodes that are most likely to be malignant, known as sentinel nodes.

The problem is that this approach can miss cancer in nearby axillary lymph nodes, which are typically found under the armpits, lead researcher Dr. Kelly Hunt, chief of surgical breast oncology at the M.D. Anderson Cancer Center in Houston, and colleagues explained.

Although having only the sentinel nodes removed is a plus in terms of preventing crippling side effects such as arm swelling, loss of shoulder movement and pain, the question remained that if the sentinel nodes were cancer-free, did that mean the axillary lymph nodes were also cancer-free, Hunt said.

To try to answer that question, the researchers determined that if sentinel lymph node surgery missed cancerous axillary nodes only 10 percent of the time, then the procedure could be a good alternative for these women.

"We didn't quite make that point," said Hunt. "The false-negative rate was 12.6 percent."

In the study, the overall false-negative rate was based on the removal of two sentinel nodes.

However, Hunt's team did find that when three sentinel lymph nodes were removed and two types of mapping tests were used before the procedure, the false-negative rate did fall below 10 percent.

"This is a huge step forward, because now we know we can use these surgical standards to make the next step toward reducing the extent of axillary surgery," Hunt said.

Not all experts agreed with that assessment. The authors of an accompanying editorial said that the approach may only be beneficial for a small number of women with breast cancer.

"In patients who start out with cancer in their underarm lymph nodes and get chemotherapy, sentinel lymph node biopsy is only an accurate way of determining whether cancer is still left in those lymph nodes if you find three or more sentinel lymph nodes," said editorial co-author Dr. Monica Morrow, chief of breast service at Memorial Sloan-Kettering Cancer Center in New York City.

"Many women aren't going to meet this criteria," she explained, because in most cases there aren't three sentinel lymph nodes. "So, this applies to a relatively small proportion of women -- about a quarter of them."

In the future, when more and better targeted drug therapy is available, sentinel lymph nodes surgery alone might be applicable to more women, she added, and the editorial stated that the less-invasive approach should not become standard practice at this point.

The report was published online Oct. 7 in the Journal of the American Medical Association, to coincide with the presentation of the findings at the American College of Surgeons meeting in Washington, D.C.

More information

For more on breast cancer, visit the American Cancer Society.

Copyright © 2013 HealthDay. All rights reserved.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


Latest News

CNY Brain Aneurysm Awareness Campaign Raises Funds for Crouse Neuroscience Institute
more >

MedEx Bedside Prescription Delivery Service

Free service offers convenience, patient education at discharge.
more >

Weight Loss Surgery

Is it right for you? Attend a free information seminar held twice monthly.
more >

Quality at Crouse

See how Crouse Hospital strives to provide the best in patient care.
more >

Cheer Up That Special Someone

Say get well or welcome a new arrival with a gift purchased right at Crouse.

more >

Make an Online Donation Now

Your donation of any amount helps support Crouse services & programs in a meaningful way.
more >

Shop Online Now

Say get well, thinking of you or welcome new baby with a unique gift from the Crouse Gift Shop.

more >