Axillary surgery not necessary for all invasive breast cancer patients, reveals study
UCLA researchers have found in a new study that more women could potentially be spared an axillary lymph node dissection -- the surgical removal of 10-20 lymph nodes -- a procedure that causes disabling arm swelling in up to 25% of women.
The procedure is currently a standard part of surgical treatment for women with breast cancer that has spread to the lymph nodes to determine the extent of the cancer's spread. However, the team found that over 40% of women with lymph node involvement at diagnosis have only 1-3 positive nodes at surgery with the remainder of nodes removed being normal. The team also identified certain features of a patient's tumor -- tumor size, lobular histology and nodal metastasis size -- that can predict which patients may be suitable for omission of this procedure.
Most women with invasive breast cancer are recommended for axillary surgery at the time of their breast surgery. Axillary surgery is a staging procedure that helps determine whether breast cancer has spread outside of the breast. Cancer cells can travel directly through the bloodstream to distant organs (bones, lungs, liver, brain) or via the lymphatics. There currently is no blood test that is able to detect cancer cells in a meaningful way so physicians rely on the lymph nodes to determine whether cancer has started to spread.
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