Study: classic lymph node removal for breast cancer unnecessary

Study: classic lymph node removal for breast cancer unnecessary

Most commonly, women diagnosed with early stages of breast cancer have been going through a painful procedure to remove cancerous lymph nodes directly from the armpit. However a new study published this week, may change this course of action and spare women grief. Surgeons have been removing lymph nodes from under the arms of breast cancer patients for decades, believing it would prolong women's lives by keeping the cancer from spreading or coming back.

Cancerous lymph nodes mean that a person has developed either a primary form of cancer within the lymph, more commonly known as lymphoma, or a secondary form of cancer, which would be metastatic cancer, where the cancer has spread into one or more of the lymph nodes. No matter how the cancer of the lymph nodes came about, there are a few very distinct symptoms that can help indicate whether one is suffering from this particular condition.

For most people, the first symptom of a cancerous lymph node is some level of inflammation or swelling of a lymph node. This can be felt (and sometimes seen with the naked eye) within lymph nodes in the neck, armpit or groin. A swollen lymph node is fairly firm and raised, but offers no real pain or tenderness to the touch. Basically, it seems just like a swollen gland.

As with many forms of cancer, cancer of the lymph nodes usually brings with it a certain amount of fatigue and exhaustion. This is partly due to what the cancer is actually doing to the body. Cancerous cells essentially use more calories than an average, healthy cell, leading to undernourishment and eventually a heightened fatigue or exhaustion. Also, the body naturally tries to fight these cancerous cells, which inevitably takes a toll on the system and wears a person out.

Worldwide, breast cancer comprises 10.4% of all cancer incidences among women, making it the most common type of non-skin cancer in women and the fifth most common cause of cancer death. In 2004, breast cancer caused 519,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths). Breast cancer is about 100 times more common in women than in men, although males tend to have poorer outcomes due to delays in diagnosis.

Approximately, 40,000 women a year in the United States are affected by early stage breast cancer, and the procedure to remove lymph nodes can cause complications like infection and lymphedema, a chronic swelling in the arm that ranges from mild to disabling. However a sweeping change to treating this condition is taking the medical profession by storm.

The new findings are part of a trend to move away from radical surgery for breast cancer. Rates of mastectomy, removal of the whole breast, began declining in the 1980s after studies found that for many patients, survival rates after lumpectomy and radiation were just as good as those after mastectomy.

Dr. Armando E. Giuliano, the lead author of the study and the chief of surgical oncology at the John Wayne Cancer Institute at St. John's Health Center in Santa Monica, Calif., said:

"It shouldn't come as a big surprise, but it will. It's hard for us as surgeons and medical oncologists and radiation oncologists to accept that you don't have to remove the nodes in the armpit. The low rates of locoregional recurrence at five years and the nearly identical overall and disease-free survival between treatment groups in [this trial] would suggest that differences in survival between study groups are unlikely to emerge with longer follow-up, because ALND would only affect survival by virtue of improved locoregional control."

Prognosis and survival rate of breast cancer varies greatly depending on cancer type and staging. Computerized models are available to predict survival. With best treatment and dependent on staging, 10-year disease-free survival varies from 98% to 10%. Treatment includes surgery, drugs (hormonal therapy and chemotherapy), and radiation.

Source: Journal of the American Medical Association

Lymph node study may change treatment of breast cancer (Video Medical And Professional 2020).

Section Issues On Medicine: Women health