Crouse Health Online: Wellness is just a click away.
Share Share
  |  Connect with Us: 
large
med
small
Text Size
 

Health News



Lymph Node Test Doesn't Improve Breast Cancer Care, Study Finds

Lymph Node Test Doesn't Improve Breast Cancer Care, Study Finds

08/01/11

TUESDAY, July 26 (HealthDay News) -- A special staining process that often accompanies a lymph node-sparing test is not associated with longer survival times for women with early-stage breast cancer treated with breast-conserving surgery, a large, new study suggests.

Examining the medical records of more than 5,200 patients who underwent breast-conserving surgery for early, invasive breast cancer, researchers found that tiny cancer cells in the sentinel lymph node -- the first node to which malignant cells are likely to spread from a primary tumor -- detected with a diagnostic procedure called immunohistochemical (IHC) staining had no effect on overall survival.

The biopsy procedure, known as sentinel lymph node (SLN) dissection, has been praised for averting the removal of large numbers of armpit lymph nodes during breast cancer surgery, which can lead to a painful buildup of fluid called lymphedema.

In this new study, the researchers wanted to determine the association between immunochemical staining of SLNs and bone marrow specimens taken from patients with early-stage breast cancer, and those patients' survival and risk for metastatic cancer.

"I think I'd have to say it was highly controversial whether these occult [hidden] metastases would be clinically relevant," said study author Dr. Armando Giuliano, chief of surgical oncology at Cedars-Sinai Medical Center in Los Angeles. "If it's not going to affect mortality, it shouldn't affect treatment."

The study is published in the July 27 issue of the Journal of the American Medical Association.

The observational study included data from women included in the American College of Surgeons Oncology Group trial at 126 sites from May 1999 to May 2003, and all patients were followed until April 2010. Results were blinded to treating physicians to avoid the bias of overtreatment, Giuliano said.

At a midpoint follow-up of 6.3 years, 435 women had died and 376 experienced recurrence of their cancer. Based on IHC staining, five-year overall survival rates of those whose samples tested positive for node involvement were 95.1 percent, compared to 95.7 percent for those whose SLN biopsies tested negative. Corresponding five-year rates of disease-free survival were 90.4 percent and 92.2 percent, respectively.

Giuliano said the research, when adopted clinically, can save patients several hundred dollars or more in unnecessary tests. Women with microscopic metastases in their SLNs can also be spared from certain more aggressive treatments that were thought to increase their survival rates, he said.

Dr. Lora Weiselberg, chief of breast cancer service at the Monter Cancer Center of North Shore-LIJ Health System in Lake Success, N.Y., said many physicians have questioned the significance of the use of IHC for all sentinal lymph node biopsies.

"In certain cases . . . we would want to do [IHC staining] anyway, but otherwise I think this is very strong evidence," Weiselberg said. "I think more and more pathology laboratories are going to go in that direction [of fewer tests] because adding another costly test, if it's not going to help the patient, is unnecessary."

More information

The U.S. National Cancer Institute has more on sentinel lymph node biopsies.

Copyright © 2011 HealthDay. All rights reserved.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

OF INTEREST:
 

Latest News

Crouse Hospital Appoints Chief Information Officer
more >

MedEx Bedside Prescription Delivery Service

Free service offers convenience, patient education at discharge.
more >

CrouseSports Express After-Hours Ortho Care

Immediate care of orthopedic injuries in kids and adults.
more >

Weight Loss Surgery

Is it right for you? Attend a free information seminar held twice monthly.
more >

Quality at Crouse

See how Crouse Hospital strives to provide the best in patient care.
more >

Cheer Up That Special Someone

Say get well or welcome a new arrival with a gift purchased right at Crouse.

more >

Make an Online Donation Now

Your donation of any amount helps support Crouse services & programs in a meaningful way.
more >

Shop Online Now

Say get well, thinking of you or welcome new baby with a unique gift from the Crouse Gift Shop.

more >