Many breast cancer patients can skip aggressive lymph node surgery without increasing their chances of a recurrence or death if their disease shows limited spread, according to a study that has prompted changes in practice.
Under current guidelines, the often-debilitating surgery is done if the cancer has spread outside the breast to any lymph nodes.
In the study, rates of survival and of patients' remaining cancer-free were just as good whether the women with limited spread - in one or two nearby nodes - had lots more underarm nodes removed or skipped that major surgery.
At least 24,000 of the 180,000 U.S. women diagnosed every year with breast cancer have limited spread to lymph nodes. Under the standard approach, they would have a chunk of underarm tissue removed to check for further cancer spread, said Dr. Thomas Julian, a breast cancer specialist with West Penn Allegheny Healthcare System in Pittsburgh. He was not involved in the study.
That operation often leaves women with lasting arm swelling, stiffness and pain.