A less invasive technique called sentinel node resection is as safe and effective as traditional surgery of removing all lymph nodes from the underarm area for women with breast cancer, according to a new study being presented today at the American Society of Clinical Oncology (ASCO) meeting by oncologists from the National Surgical Adjuvant Breast and Bowel Project (NSABP) and Allegheny General Hospital (AGH) in Pittsburgh.
The 10-year follow up of the largest-ever Phase III trial comparing the two methods’ effect on breast cancer survival and recurrence shows no significant difference in overall survival or disease-free survival, said Thomas B. Julian, MD, Associate Director of the Breast Care Center at AGH and one of the clinical trial’s principal investigators, along with Norman Wolmark, MD, a surgical oncologist at AGH who serves as Chair of the NSABP. Dr. Julian presented the trial results this morning at the annual ASCO meeting in Chicago.
“Removal of lymph nodes can result in painful complications for women with breast cancer,” Dr. Julian said. “This 10-year follow-up shows that women with node-negative breast cancer, the most common kind, can feel confident that a less-invasive sentinel node resection is equally effective and safe. Sentinel node resection is clearly the standard of care for these women.”
Each year, more than 200,000 women in the United States are diagnosed with breast cancer, and almost 40,000 will die from it. With early detection, the five-year survival rate is as high as 90 percent.
The study enrolled 5,611 women with invasive breast cancer over a period of five years and randomly assigned them to sentinel node resection alone or sentinel node resection plus complete axillary dissection of the lymph nodes. Ten years after their surgeries, the researchers continued to find no significant difference between the two groups of women in overall and disease-free survival. Additionally, the use of special stains to find occult tumor cells in the lymph nodes offers no additional benefit for the patient.
Removing all lymph nodes from the underarm area carries the risk of difficult and sometimes permanent complications, including lost sensation in the back of the arm, tingling, weakness and swelling (lymphedema).
Sentinel nodes are normally the first lymph nodes to receive drainage as well as cancer cells from the breast tumor. Doctors can find the sentinel nodes and remove them with a small surgical procedure. If no cancer is found, removal of the remaining lymph nodes is not necessary.