Lymph node surgery for breast cancer patients—Can I get by with less?

By Debbie Saslow, PhD

 

A recent study has shown that for some women diagnosed with breast cancer, extensive lymph node surgery isn’t needed. This is great news because removal of lymph nodes in the armpit area can have debilitating and life-long side effects.

Here is a little background: In the United States, about 210,000 new cases of invasive breast cancer will be diagnosed this year. Of the invasive cancers, about 30% of cases, or 63,000 cancers, will be diagnosed at the “regional stage,” which means the cancer has spread to nearby lymph nodes. The findings of this study are important for women in this group.

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The women who participated in the study:

  • had breast cancer that had spread to the first 1 or 2 nearby lymph nodes,
  • had received treatment including lumpectomy and radiation therapy,
  • had tumors that were less than 5 cm-about 2 inches-across, and
  • did not have any lymph nodes in the armpit that could be felt during examination.

While not a requirement of the study, almost all of the women participating also had received chemotherapy after, but not before, their lumpectomy.

 

Nine hundred women participated in the study. Half had just 1 or 2 lymph nodes removed using a procedure called sentinel lymph node dissection. The other half had at least 10 lymph nodes removed from the armpit area using a procedure called axillary lymph node dissection.

 

Survival was measured after 5 years and was found to be the same in both groups — about 92% — suggesting many women can avoid the more extensive removal of lymph nodes along with its common and often debilitating side effects. These side effects include lymphedema (swelling of the arm, shoulder, or hand that can limit movement), tingling sensations, and wound infections.

 

Does this mean that all women diagnosed with breast cancer that fits the characteristics of the women in the study can forego extensive removal of the armpit lymph nodes? In many cases, the answer is yes. But keep in mind that this was just one study. However, the findings build on previous research suggesting that the less extensive sentinel lymph node dissection is safe for these women. Another caveat to note: while the study required that tumors be less than 5 cm, most of the study participants actually had tumors that were less than half that size.

 

Women who meet some but not all of these criteria may not be eligible for this treatment plan. If you or a loved one has been diagnosed with breast cancer, and you have questions about how this affects your treatment plan, talk to your doctor right away.

4 thoughts on “Lymph node surgery for breast cancer patients—Can I get by with less?

  1. Dr. Saslow, would you mind providing a link to that study? I’m up for surgery in a couple of months and if it’s good, sound science, I’m keeping my lymph nodes! Thanks in advance….

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