United States: Lymph nodes are extracted from the armpit in many breast cancer patients, which later can result in lymphedema, a painful and unsightly swelling of the arm.
Lymph removal is needed by some patients – Study
According to a Swedish team of researchers, determined which patients need extensive lymph node removal, based solely on the number and size of the tumors infiltrating lymph nodes and which patients won’t.
Some progress has also been made in demonstrating a certain degree of efficiency toward finding the answer to the question of whether a complete lymph node removal is always necessary.
It has been known for some time now that when any breast cancer spreads to the nodes, whether it is to the lymph nodes or some other nodes in the body, the choice for the patient is to make removal of the nodes part of her treatment.
Nevertheless, when considering that cancer has not spread beyond the breast so far, a few “sentinel nodes” usually get removed and tested by a physician to see whether tumor cells are also present in the node.
If the sampling showed minimal findings like a single cancer cell or cancerous spots that are only 2mm in size or less, further lymph node excision is not necessary, as US News reported.
Observational study by scientists
In order to assist breast cancer patients in interpreting the results of their negative findings, de Boniface and colleagues conducted an observational study in which they followed the outcomes for almost 2800 patients from different countries. Moreover, all of them have a sentinel node or metastasis spread size above 2 millimeters in one node or two.
The studies were conducted in such a way that the group was split into two m. The armpit node removal was more complete for the patients in one of the groups and the other group of patients were left as is.
All patients, furthermore, were documented to have undergone post-surgical chemo and/or radiation therapy, which helped in picking up those cancer cells that may have passed unnoticed, the Swedish researchers pointed out.
Investigators observed that in one third of patients who had the procedure with more complete lymph node removal, the lesions were further evaluated to find the signs of spread of this tumor.
The investigators would assume that stage of lymph node metastasis that was present in the women who underwent additional lymph nodes removal was similar to the case of those who underwent the same procedure.
The downside of removing radical lymph – Researchers
However, the researchers also demonstrated the downside of choosing for more radical lymph removal because 13 percent of patients who had done so went on to see debilitating lymphedema, as compared to 4 percent of those who had gotten their sentinel nodes removed.
De Boniface said, “Our assessment is that it is safe for patients to forgo axillary dissection [node removal] if there are a maximum of two macrometastases in the sentinel lymph nodes, US News reported.
Further added, “In these cases, axillary dissection is replaced with radiation therapy to the armpit, which results in less arm-related complications,” and, “This has now been implemented in clinical practice in Sweden,” as de Boniface added.