Extended versus Targeted Lymph Node Surgery for Invasive Breast Cancer

This study compared survival rates for two surgical strategies in treating invasive breast cancer. The main finding was that the targeted Sentinel Lymph Node Dissection (SLND) procedure was just as effective as the traditional Axillary Lymph Node Dissection (ALND) surgery.

Lymph from the breast drains towards the armpit encountering several lymph nodes along the way. Breast cancer first spreads to some of these nodes before reaching other areas of the body. The ALND or SLND procedures prevent cancer from spreading by removing lymph nodes to which tumor cells have migrated. The traditional procedure involves the removal of most armpit lymph nodes. Despite being very effective, it also leads to complications such as impaired lymph drainage from the arm and infections. SLND is an alternative procedure which involves highlighting and removing only the first lymph nodes to which cancer from the breast has spread, thus eliminating most complications associated with an extended lymph node operation.

The study involved two groups of patients (with SLN metastases identified by SLND), one treated with ALND (420 women), the other with SLND only (436 women). Besides the lymph node procedures, surgery to remove the primary tumor, radiation therapy and chemotherapy were also used in all patients. Survival rates at 5 years after the surgery did not differ significantly between the two groups, both values being over 90% (92.5% for SNLD, 91.8% for ALND).

These results prove that the modern, targeted approach is just as effective as the traditional ALND procedure, offering excellent survival rates and limiting potential side effects. SLND is thus offered to women along breast conservation and systemic therapy.

You should discuss with your doctor if SLND is the right option for you.