New Lymph Node Study Proves Less Can be More in Breast Cancer Care

Thursday, February 10th, 2011

Lymph Node Removal May Not be Necessary, Meaning a Less Invasive Procedure for Qualifying Breast Cancer Patients

JAMAFor 20 percent of breast cancer patients, the results of a study published in the Journal of the American Medical Association (JAMA) could lead to a less invasive treatment plan. The study reveled that removing cancerous lymph nodes in the armpits – a standard practice in treating breast cancer – has no advantage for certain patients.

“There was a time when the treatment of choice for women with breast cancer was to remove the entire breast via a mastectomy,” said Dr. Mansoor Saleh, principle investigator and director of clinical research at Georgia Cancer Specialists. “Today we know that in most women, removing the actual tumor lump via a lumpectomy, plus radiation to the breast, is just as effective as the very invasive mastectomy. This new lymph node study is equally exciting and groundbreaking for the oncology world.”

A process called sentinel lymph node sampling (SLN) enables physicians to identify patients whose breast cancer has spread to their axillary lymph nodes (located in the armpits). Previously, women who had a positive SLN were thought to require an axillary lymph node dissection (ALND) – a procedure that carries a number of side effects, including pain, secondary infections, and the risk of chronic and debilitating lymphedema of the arm.

The study, released by Dr. Armando E. Giuliano and colleagues, showed that women with breast tumors less than 5-centimeters (known as “T1-2” tumors) might not need to undergo ALND even if they have a positive SLN. Women with T1-2 tumors who participated in the study and underwent a lumpectomy and SLN followed by radiation therapy to the breast (and appropriate adjuvant therapy) did just as well as the women who underwent ALND.

“These findings are of major significance for women with breast cancer and one more example of the importance of clinical research,” Dr. Saleh said. “After all, it is only through participation in clinical trials that address such pivotal questions that we can improve the care of patients with cancer.”

Dr. Saleh is principal investigator and director of clinical research of GCS’s community-based Phase I-IV clinical research program. He offers comprehensive cancer care at the GCS-Northside location (1100 Johnson Ferry Rd., Suite 600, Sandy Springs; 404-256-4777).

Georgia Cancer Specialists is a Top 10 private cancer practice in the U.S. and a leader in advanced cancer treatment and research. The practice supports more than 200,000 patient visits each year. GCS offers community-based medical oncology and hematology services and is the first private oncology practice to also provide a full range of support services for patients in Georgia, including nutritional counseling, pain management, wellness counseling, and home health coordination. The GCS research department, whose focus is bringing targeted cancer therapy to communities, is the first in Georgia to offer Phase I clinical trials, the most novel cancer therapies available. GCS has 29 offices, 44 physicians, and more than 500 support staff members located in Metro Atlanta, North and Central Georgia, Southeast Tennessee, and Southwest North Carolina. Georgia Cancer Specialists can be found on the web at GCS is The Cancer Answer.

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