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New Test Better Predicts Breast Cancer Spread

Sentinel Node Biopsy Has Fewer Complications Than Older Technique
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WebMD Health News

Dec. 9, 2004 (San Antonio) - A newer type of biopsy better predicts breast cancer spread than the older, more invasive procedure.

Sentinel lymph node biopsy, which involves removing just a few key lymph nodes, works just as well as removing the usual 10 to 20. And the newer procedure has fewer complications, new research shows.

During breast cancer surgery to remove the tumor, lymph nodes from the armpits are removed to check for cancer spread. Lymph nodes collect fluid that drains from various parts of the body. Lymph nodes are typically the first place where breast cancer that has spread is found.

However, severe, painful swelling in the arm is common if many of these lymph nodes are removed. That's the benefit of sentinel lymph node biopsy.

During sentinel lymph node biopsy, only the first lymph node that filters fluid from the breast is removed. The lymph node is then examined for cancer cells.

Sentinel lymph node biopsy is already offered to many women with breast cancer. But there haven't been any large, well-designed studies proving it works, doctors say.

In a study of more than 5,000 women with breast cancer, sentinel node biopsy was just as accurate as the older technique, called axillary node dissection, in predicting breast cancer spread, says Thomas B. Julian, MD, a cancer specialist at the Allegheny Cancer Center in Pittsburgh and head of the study.

And a second study of more than 1,000 women -- and a few men -- with breast cancer showed that there's less pain, swelling, and numbness in the arms and shoulders associated with sentinel node biopsy than with the older technique. There are also fewer problems with mobility.

People "can go about their normal business quicker," says researcher Mark Kissin, MD, a breast cancer surgeon at Royal Surrey County Hospital in Guildford, England. "There really shouldn't be a choice anymore. Sentinel node biopsy must be the standard of care."

Daniel Osman, MD, director of the Miami Breast Cancer Conference, says the new research will boost confidence in the technique.

Sentinel node biopsy diminishes the complications associated with removing many lymph nodes, he says. "So if it's just as accurate, why not do it?"

The findings were presented Thursday at the annual San Antonio Breast Cancer Symposium.

Breast Cancer Test Proves Reliable

Julian studied 5,260 women; all had a sentinel node biopsy. Half then went on to have the standard procedure where multiple lymph nodes are removed. The other half only had the more aggressive procedure if the sentinel node contained cancer.

Sentinel lymph node biopsy involves injecting a dye, which migrates to the lymph node or nodes most likely to have cancer cells in a woman with breast cancer. If the lymph node or nodes show no sign of cancer, it's almost certain that the cancer has not spread beyond the breast.

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