Quick Study: More-conservative surgery seems as good as usual breast cancer care
Removal of more lymph nodes does not seem to improve results of surgery
THE QUESTION When a woman has a lumpectomy or mastectomy, lymph nodes in the underarm area are usually removed as well. Sometimes just the sentinel nodes (the first set of lymph nodes to which the cancer is likely to spread) are taken out; other times, all underarm lymph nodes are removed. Is one treatment method safer than the other?
THIS STUDY randomly assigned 3,989 women scheduled for breast cancer surgery to have only sentinel lymph nodes removed or to have all lymph nodes in the underarm removed. Subsequent treatment with radiation, chemotherapy or hormone therapy was comparable in the two groups. After an average of eight years, virtually no differences were found between the groups in the rates of recurrence or spread of the cancer. In both groups, less than 1 percent of the women had died, and about 84 percent were alive and cancer-free.
WHO MAY BE AFFECTED? Women with breast cancer having a lumpectomy or mastectomy. An estimated one of every eight women in the United States will develop breast cancer at some point in their lives, with more than 200,000 new cases diagnosed each year.
CAVEATS Most of the study participants' cancer tumors were small, and nearly all of the women were white; whether the findings would apply to other women is unclear.
FIND THIS STUDY October issue of The Lancet Oncology.
- Linda Searing
The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.