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Sentinel lymph node biopsy associated with better quality of life in breast cancer patients

Biopsy of the sentinel lymph node, the first lymph node to which fluid from a primary breast tumor drains, was associated with better arm function and better quality of life compared with standard dissection, or removal of lymph nodes in the armpit region in women with early-stage breast cancer, according to a study in the May 3 Journal of the National Cancer Institute. The authors suggest this minimally invasive procedure is a safe and effective alternative to more invasive lymph node dissection and removal.

While patients with invasive breast cancer no longer undergo automatic mastectomy, routine removal of lymph nodes in the armpit region (standard axillary dissection) is still commonly carried out in order to find and take out lymph nodes with cancer in them. However, lymph node removal can cause a number of unpleasant side effects, such as decreased arm and shoulder function. For women with early-stage breast cancer, this type of surgery has little benefit, and some scientists suggest doctors could evaluate breast cancer using a less invasive technique called sentinel lymph node biopsy, where the first lymph node to which fluid from a primary breast tumor drains, is removed and examined.

Robert E. Mansel, of the Wales College of Medicine at Cardiff University in the United Kingdom, and colleagues examined data from 1031 breast cancer patients in the randomized ALMANAC trial, half of whom received sentinel lymph node biopsy followed by lymph node removal, the other half of whom underwent lymph node removal. Data on patients was collected between November 1999 and October 2003.

The authors found that sentinel lymph node biopsy was associated with better arm function, better quality of life, a shorter hospital stay, and faster recommencement of daily activities than standard axillary lymph node dissection. In addition, women who underwent a sentinel lymph node biopsy had a low recurrence rate of cancer and had survival rates equiva
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Contact: Ariel Whitworth
jncimedia@oxfordjournals.org
301-841-1287
Journal of the National Cancer Institute
2-May-2006


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