Sentinel Lymph Node Biopsy and Complete Axillary Dissection in Node-negative BC.
According to an article recently published in the Annals of Surgical Oncology, no significant survival differences exist between patients with node-negative breast cancer who undergo sentinel lymph node biopsy and those who undergo a complete axillary lymph node dissection.
Node-negative breast cancer refers to cancer that has not spread from its site of origin to any nearby lymph nodes. Standard therapeutic options tend to produce optimal long-term survival for these patients.
For over 30 years, the standard for early breast cancer staging has included the removal of approximately 10 to 25 axillary (under the arm) lymph nodes to help determine whether the cancer has spread. This procedure, called an axillary lymph node dissection (ALND), can be associated with chronic side effects, including pain, limited shoulder motion, numbness, and swelling.
A more recent approach for evaluating whether cancer has spread to the lymph nodes is sentinel lymph node (SLN) biopsy. This procedure’s advantage is that only a small number of sentinel nodes (or even a single node) are removed. Sentinel nodes are the first lymph nodes to which cancer is likely to spread.
Sentinel lymph node biopsy is becoming more widely adopted in the clinical setting for determining whether cancer has spread to the lymph nodes in women with localized breast cancer. There is some evidence that the procedure improves quality of life compared to ALND. Follow-up regarding survival continues to be evaluated.
Researchers from the University of South Florida recently evaluated data comparing survival rates between women who had received an ALND to those who had received an SLN. This study included 2,458 patients; 25% were treated with ALND and 75% were treated with SLN. All participants had been diagnosed with node-negative breast cancer. Patients were treated between 1986 and 2004.
- Overall survival rates were similar between women who underwent an ALND and those who underwent an SLN.
- Cancer-free survival rates were similar between the two groups of women.
The researchers concluded that overall survival and cancer-free survival rates are similar among node-negative breast cancer patients who undergo an ALND and those who undergo an SLN. These results provide further evidence that SLN is an appropriate choice for patients with node-negative breast cancer. However, patients should ask their surgeons about the number of SLN procedures they have performed because the accuracy of results may depend on surgeon experience.
Reference: Cox C, White L, Allred N, et al. Survival Outcomes in Node-Negative Breast Cancer Patients Evaluated With Complete Axillary Node Dissection Versus Sentinel Lymph Node Biopsy. Annals of Surgical Oncology. 2006; 13:708-711.
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