There’s new good news in the world of breast cancer treatment.
A study authored by Dr. Guilliano (the surgeon who first gave us sentinel node biopsy in 1994) and published in JAMA this past week confirms prior studies showing that axillary dissection does not impact overall survival from breast cancer. The study confirms what has been debated for many years – that it’s enough to know whether or not one lymph node is involved with cancer; the surgeon doesn’t need to take any more. Reviewing the sentinel node status is enough to determine whether a woman will need adjuvant therapy. This study proves that in most cases, the lymph nodes can be left alone even if there are others involved with cancer: the chemotherapy and radiation therapy will do just as good a job controlling the disease whether or not all the involved lymph nodes are removed. Why is this, you may be asking yourself?
Because of all the treatment options – surgery, chemotherapy, radiation therapy – it is the chemotherapy that provides the greatest survival benefit. So for many years, we thought that cutting out as much cancer as possible, including removing every single lymph node that might contain even one cancer cell, would produce the best outcomes. However, it is chemotherapy that works best to remove cancer cells, including the ones that might have taken up residence in the lymph nodes. And all that is needed to know about the axillary (or armpit) to determine chemotherapy for many women, is whether or not the sentinel node is positive.
Ok, so its a little late for those women who are struggling with lymphedema (swelling of the nearby area where lymph nodes are removed or radiated, such as the arm for breast cancer). But, its great news for any woman who will be diagnosed with breast cancer going forward. Now that we know that axillary dissection does not improve overall rates of survival, this invasive surgery, which is known to have numerous complications that can negatively affect womens’ quality of life, will become far less common.
Less lymphedema for the world is a very, very good thing.