Lymph Node Surgery for Breast Cancer

For decades, the standard treatment for women who have been diagnosed with early-stage breast cancer has been to perform a biopsy on a nearby lymph node, called a “sentinal” lymph node, to see if the cancer has metastasized beyond the breast. If it has, then the usual recommendation is surgery to remove some or most of the thirty axillary (armpit) lymph nodes as well, to try to halt the spread of cancer. The surgery is extensive, and recovery is painful and slow.

A new study published in the Journal of the American Medical Association reports that removal of armpit lymph nodes may not be necessary any more, given the current effectiveness of post-surgical radiation therapy and chemotherapy. In the study, 891 women who had undergone a lumpectomy for early stage breast cancer were randomly assigned to just sentinal node removal, or removal of at least 10 of the axillary lymph nodes. There were no differences in survival rates or disease-free survival rates between the two groups for the entire eight years of the study.

The authors recommend that physicians consider carefully whether more radical axillary node surgery is really necessary in most patients. Some cancer centers are already starting to change their cancer treatment protocols as a result of these new findings.