In most cancer patients, axillary-lymph-node dissection (ALND) involves the removal of most of the lymph nodes in the underarm region to improve the chances of survuval, but sometimes it causes damages to the patients' arm and shoulder.
American scientists found that sentinel-lymph-node surgery (SLN), a less invasive technique that only removes the sentinel nodes, the ones closest to the breast, is safe and effective.
5,611 American women whose breast cancer did not appear to have spread to their lymph nodes were recruited to assess their differences in survival rates between the 2 types of surgery. Half of the patients had ALND surgery to remove all of the lymph nodes in the underarm area, while the other half had SLN surgery to remove the sentinel lymph nodes only. Patients were tracked over the next eight years.
The researchers found no significant differences in the patients' survival rates between the two groups. Patients who underwent the SLN procedure were less likely to experience arm problems or lymphoedema (chronic swelling of the arm). The authors concluded that "SLN surgery alone with no further ALND is an appropriate, safe, and effective therapy for breast cancer patients with clinically negative lymph nodes" and that SLN surgery "represents the next major step in reducing the extent of surgical procedures to treat breast cancer".
An accompanying comment said that the paper "vindicates contemporary practice of SLN biopsy and provides support for a reduction in extent of axillary surgery for most patients with breast cancer".
Source: Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncology, 11(10):927 - 933. Published Online: 21 September 2010 (f/t via Athens)
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