"We are concerned about the numbers because it really hasn't been proven for breast cancer that you should forgo the axillary node dissection," Scott-Conner said. "Our results were fairly striking. The survival was significantly worse for patients who did not have the dissection.
"If this had been the only study, then I would say, 'Well, we need to get more information.' But there was a similar study from the Rhode Island Tumor Registry. Because it was a smaller group within a single state, they were able to do much more careful analysis of the data. Their results were very similar. I just don't think we have enough information right now to make the leap and say that we can omit doing dissections."
The next step in the dissection debate is to study sentinel node biopsies, Scott-Conner said. This investigation is under way and should be completed in a couple of years. The sentinel node is the lymph node to which the tumor would spread first. There are a couple of ways of figuring out which is the sentinel node, Scott-Conner said. After injecting a dye around the tumor or using a radioactive tracer, cancer specialists can then look for the lymph node that has the marker concentration. This technique has proven useful for detecting melonoma.
"The idea is if you take out the sentinal lymph node and tests indicate it is not cancerous then you shouldn't have to dissect the other nodes," Scott-Conner said. "If it tests positive, you probably ought to remove more lymph nodes because they might also be cancerous."
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Contact: Jennifer Cronin
jennifer-cronin@uiowa.edu
319-335-9917
University of Iowa
20-Sep-1999