For Some Breast Cancer Patients, Node Surgery May Not Be Necessary

By Andrew Moseman | February 9, 2011 12:37 pm

For a century, one of the standard procedures for treating women with breast cancer has been the painful removal of the lymph nodes from under the arm, with the belief that this would hamper the cancer’s ability to spread, and extend patients’ lives. A study out in the Journal of the American Medical Association, however, is turning heads by suggesting that—in some cases—this common wisdom be overturned.

For women who meet certain criteria — about 20 percent of patients, or 40,000 women a year in the United States — taking out cancerous nodes has no advantage. It does not change the treatment plan, improve survival or make the cancer less likely to recur. And it can cause complications like infection and lymphedema, a chronic swelling in the arm that ranges from mild to disabling. [The New York Times]

The “20 percent of patients” are those who fit the same criteria as the breast cancer patients in this study: women with early-stage tumors and no noticeable swelling of the lymph nodes, and whose cancer hadn’t spread. All 891 women in the study had a lumpectomy, meaning not all but part of the breast was removed to get the tumor. Of the 891 women, 445 had their lymph nodes removed while 446 didn’t.

[The researchers] found no significant difference in the patients’ chances of surviving five years after their diagnosis. The five-year “disease-free” survival rate was 83.9 percent in those who did not have the more aggressive surgery compared with 82.2 in those who did, the researchers reported. [Washington Post]

The overall survival rate was 91.8% for women who had nodes removed and 92.5% for those who didn’t—again, not a statistically significant difference.

Armando Giuliano, the study’s lead author, says he was surprised at his findings. It makes logical sense to remove the nodes; cancer often spreads to them first. But the data just didn’t show the benefit connected to taking them out. Why not?

Some think the study results reflect the impact of earlier diagnosis of breast cancer combined with widespread use of chemotherapy and radiation following removal of the primary tumor. Those treatments may make it less important to remove lymph nodes containing metastatic cells. But study authors caution that there are a lot of unknowns about breast cancer cells found in lymph nodes — they may be biologically different from those that cause real trouble when they migrate to bones, liver and other organs. [NPR]

Whatever the reason, the results by Giuliano’s team–if they hold up—could mean less surgery (and risk of complications) for breast cancer patients.

Moreover, they said, because survival rates were so high at the five-year mark, it is unlikely that differences in the two groups’ survival rates will arise at the 10-year mark or later. [Los Angeles Times]

Related Content:
80beats: In Mice, Breast Cancer “Vaccine” Trains the Body to Fight Cancerous Cells
80beats: Can Breast Cancer Tumors Vanish Without Treatment?
80beats: Genetic Test Could Predict Breast Cancer Risk for Young Women
Gene Expression: Patenting the “Breast Cancer Gene”

Image: National Cancer Institute

CATEGORIZED UNDER: Health & Medicine
  • nick

    While not statistically significant, it does seem a bit odd to me that there seems to be a 1% better chance of survival WITHOUT the painful extra surgery.

    I believe this falls into the “if it ain’t broke, don’t fix it” category.

  • Michale Saragosa

    Unfortunately, there is something that I notice that needs to be pointed out. It’s something that you might be missing. Anyway, what I am thinking is that you could all be making some money with the amount of writing that you do. Making money online is a lot more simple than people make it out to be. It’s never too late to get started in Internet marketing and if you are already dabbling in the business, it’s not too late to start becoming successful at it. What if I told you that I know about a couple of software titles that could make it possible for you to excel at making money online? In a nutshell, Free Money Formula is a complete money-making system involving the use of article marketing, press releases, video marketing, podcasts, and social media. These are all cutting edge tactics that are currently used my Internet marketers and with The Free Money Formula, you get more than 120 minutes of video coaching. So if you are brand new to this, you can grab all the details in the step by step video presentations or if you are already well on your way to being a successful Internet marketer, you can skim through all of that and get right to the 2 very well-rounded pieces of software that come with this package. The 2 pieces of software that you’ll get are article marketing submission & rewriting software, and video submission software that will bring lots of traffic if used correctly. Just think, you could be just a few clicks away from finally taking control of your financial independence. Go ahead and check it out:


Discover's Newsletter

Sign up to get the latest science news delivered weekly right to your inbox!


80beats is DISCOVER's news aggregator, weaving together the choicest tidbits from the best articles covering the day's most compelling topics.

See More

Collapse bottom bar