Axillary Surgery May Not Be Required for All Women With Invasive Breast Cancer

An axillary lymph node dissection, which is the surgical removal of 10 to 20 lymph nodes from the breast, is a procedure conducted in up to 25% of women with breast cancer to disable symptoms of arm swelling. According to new research conducted at the University of California, Los Angeles (UCLA), fewer women may need such a surgery than was previously thought.

Axillary lymph node dissection is currently standard practice for women with breast cancer that has spread to the lymph nodes and it is often recommended at the time of surgery. The dissection allows physicians to determine the extent to which the cancer has spread in the body.

In the research at UCLA, the team conducted a retrospective review of data from 2010 to 2019 on patients who had positive lymph nodes at the time of their breast cancer diagnosis and were treated with a complete lymph node dissection at surgery. The researchers then assessed the data from this cohort in order to understand the extent of lymph node involvement on final pathology and whether any variables existed that may have predicted for higher nodal stage.

Previously, these women had been excluded from research into this subject due to the assumption that they needed the surgery due to the extensive spread of the cancer to the lymph nodes.

In their research, the team observed that more than 40% of women with lymph node involvement at diagnosis have 1 to 3 positive nodes at surgery, whereas the remainder of the nodes that were removed were identified as normal.

Additionally, they found that there were certain features of the tumor, such as size, lobular histology, and nodal metastasis size, that allowed for the prediction of which patients may not need this procedure.

The authors of the study note that this new information has the ability to allow for improved quality of life for patients, which allows for the crucial reduction of the long-term effects of treatment. They also explain that an important next step is for further studies to be conducted in order to validate these identified predictors.

REFERENCE

Axillary surgery may not be necessary for all women with invasive breast cancer. Los Angeles: University of California, Los Angeles Health Sciences; October 22, 2020. https://www.eurekalert.org/pub_releases/2020-10/uoc--asm102220.php. Accessed October 26, 2020.