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.
Yes, it’s in the early stages of research. And yes, it’s been tested only on mice. But the procedure developed by Vincent Tuohy and his team, billed as a preliminary breast cancer vaccine, has raised hopes once more that one day in the not-too-distant future such a procedure could be available for humans.
In a study this month in Nature Medicine, Tuohy tested the vaccine on mice genetically engineered to be more cancer-prone. The ones that received the full vaccine, with a protein called a-lactalbumin, didn’t develop breast cancer. All the others did.
Cancer presents a quandary that viruses don’t in terms of developing vaccines, experts point out. While viruses are recognized as foreign invaders by the immune system, cancer isn’t. Cancer is an over-development of the body’s own cells. Trying to vaccinate against such cell over-growth would effectively be vaccinating against the recipient’s own body, destroying healthy tissue [CBS News].
Breast-feeding may significantly cut a woman’s risk of breast cancer if she has an immediate relative that has ever had the disease, according to a study published in the journal Archives of Internal Medicine.
Among women with close family members who have had breast cancer, the risk of developing the disease before menopause sank by 59 percent if she ever breast-fed, according to the research, which used data from more than 60,000 subjects of the Harvard Nurses’ Health Study. The risk of breast cancer in women without the disease in the family was unaffected by breast-feeding. The findings suggest that breast-feeding may prove just as effective a strategy for high-risk women as the use of Tamoxifen, a drug that interferes with estrogen activity and is often used in high-risk women to reduce breast cancer risk [The New York Times]. For women with a high risk of breast cancer, due to factors like a family history of the disease or a genetic predisposition to develop it, the only preventive measures currently used are Tamoxifen and the prophylactic removal of the breasts.