Many women with early stage breast cancer don’t need to undergo additional surgery to remove cancerous lymph nodes in their armpits, a landmark study has found.
For decades, doctors have routinely performed the procedure – known as axillary lymph node dissection – because they assumed it was essential to surgically remove all the cancerous cells that had already spread from the breast to the armpit region. But eliminating the cancerous lymph nodes often leads to long-term complications, including swelling in the arm, chronic pain and increased risk of infections.
In the new study, led by Armando Giuliano of Saint John’s Health Center in Santa Monica, Calif., the researchers followed 891 patients, half of whom had their armpit lymph nodes removed.
All of the women underwent a lumpectomy, in which the tumour is cut from the breast, and they received radiation and chemotherapy. (The lymph nodes closest to the cancer, the so-called sentinel lymph nodes, were removed in all cases.)
After five years of observation, there was no difference in survival rates between the two groups of women, according to the findings published in the Journal of the American Medical Association.
The researchers believe that, in most cases, radiation and chemotherapy can wipe out the microscopic cancer cells in the armpit region, eliminating the need for these lymph nodes to be excised.
There are some circumstances in which the procedure is still warranted. But many women can now be spared the unnecessary agony of additional surgery, the researchers concluded.