MSKCC investigators have pioneered the use of nomograms to predict outcomes for patients with cancer to help them and their physicians decide which treatment approach is likely to result in the greatest benefit for individuals with a variety of malignancies, including prostate cancer, renal cancer, and sarcoma. The new nomogram is designed specifically for patients whose breast cancer has been found in their sentinel lymph nodes (the first few lymph glands that drain fluid away from the site of the cancer and are the first to which the cancer is likely to spread.)
Previous studies have shown that among women whose breast cancer has spread to their sentinel lymph nodes, about 50 percent will not have breast cancer in the other lymph nodes. The standard of care for these patients includes the complete surgical removal of the lymph nodes under the arm. However, many question the need for this operation called an axillary lymph node dissection (ALND) particularly for those who have a low risk of further axillary lymph node metastasis (women with early stage invasive breast cancer, for example).
While many research studies show that ALND will not affect how long patients live, it does reduce the chance of the cancer returning in the armpit later on; if this happens, a patient may need to have an ALND at that time. Side effects of the procedure include an increased chance of swelling and a greater risk of infection in the affected arm.
The likelihood of additional disease in the axillary lymph nodes is one of several considerations in the process of deciding whether to have further surgery. "Because the nomogram results make no actual treatment recommendations, we advise that patients discus
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Contact: Esther Carver or Melanie Johnson
mediastaff@mskcc.org
212-639-3573
Memorial Sloan-Kettering Cancer Center
3-Dec-2003