Lymph Node Management Changing in Breast Cancer Clinical Practice

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Women with breast cancer undergoing lumpectomy and sentinel node biopsy may be less likely to then have ALND.
Women with breast cancer undergoing lumpectomy and sentinel node biopsy may be less likely to then have ALND.

Women with breast cancer undergoing lumpectomy and sentinel node biopsy (SNB) may now be less likely to then have completion axillary lymph node dissection (ALND), according to research published in the Journal of the American College of Surgeons.

The results of the analysis of data from 2.7 million breast cancer patients highlight a major change in breast cancer management as a result of recommendations from the American College of Surgeons.

The recommendations are based on a study published more than four years ago, which found that most early-stage breast cancer patients with a tumor in their sentinel node didn't benefit from ALND.

RELATED: Classifying Breast Cancer Subtype May Improve Risk Stratification

Specifically, the original study -- published in 2010 -- found that women who underwent ALND did not have lower rates of cancer recurrence or better five-year survival rates than those who did not undergo ALND but were closely monitored.

This new study found that the proportion of early-stage breast cancer patients who underwent SNB alone rose from 23 percent in 2009 to 56 percent in 2011.

"As far as I know, our study is the first to show that the findings from the [2010 study] have changed clinical practice for breast cancer patients nationwide," lead author Katharine Yao, M.D., director of the Breast Surgical Program at NorthShore University HealthSystem in Evanston, Ill., said in a journal news release.

Reference

  1. Yao, Katharine, MD, FACS, et al. "Impact of the American College of Surgeons Oncology Group Z0011 Randomized Trial on the Number of Axillary Nodes Removed for Patients with Early Stage Breast Cancer." Journal of the American College of Surgeons. DOI: http://dx.doi.org/10.1016/j.jamcollsurg.2015.02.035. March 25, 2015.

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