Lymph node surgery for early stage breast cancer

This study looked at the impact of removing lymph nodes (immune glands) from the armpit (axillary nodes) in the treatment of patients with breast cancer. The study found that removing the axillary lymph nodes did not signifcantly improve survival in patients with early stage breast cancer.

Breast cancer has the ability to spread (metastasise) into the close lymph nodes in the armpit. In previous years, axillary lymph node dissection (ALND) has been used, where all the lymph nodes from the armpit are removed. This is associated with more complications such as nerve damage and arm swelling. In recent years, there has been a movement towards sentinel lymph node dissection (SLND), where only the lymph nodes closest to the breast are removed and biopsied to determine if the cancer has spread. It is important to research which of these proecedures is more effective in the treatment of breast cancer.

The study looked at 34,243 female patients with stage 1 or 2 invasive breast cancer who had had a mastectomy. The patients all had 1 or 2 lymph nodes positive for metastasis. If they had had 1-5 lymph nodes removed, they were counted as SLND patients (13,821 – 40%), and greater than 10 counted as ALND (20,422 – 60%). Anything in between was not counted.

Eighty-eight percent of the ALND group survived for 5 years after mastectomy surgery, while 85% of the SLND group survived past 5 years. 

The study concluded that sentinel lymph node dissection was similarly effective in patients with early stage breast cancer when compared to ALND.

This was a large study that analysed over 32,000 patients data. This means that their findings are likely to be correct.

If you are undergoing a mastectomy, it may be worth it to discuss with your physician the type of lymph node surgery they plan to do. This will also influence the radiotherapy that may be performed post-surgery.