Lymph Node Removal May Not Be Necessary In Some Breast Cancers

OK, this is HUGE news in breast cancer-ville! Researchers have found that for some women with early breast cancer, lymph node removal may not be necessary.

Women who’s tumors were smaller than 2 inches (T1 or T2), had a lumpectomy, and had 1 or 2 positive lymph nodes, were randomly assigned to have 10 or more additional nodes removed or to leave the nodes alone. Most of the women had radiation and chemotherapy or hormonal treatments. There was no significant difference between the two groups in 5-year survival. I’ve written more about the study on the Life-Cise News page.

This is big news! This, combined with previous research, is potentially practice-changing.

And this could make huge differences in the quality of life for thousands of women. Node removal carries risks. As many of us know, we face potential infections, pain, limited range of motion, and increased risk of lymphedema.

Imagine, not having to add worry of lymphedema to all the other worries that go with a cancer diagnosis.

But, as important as this study is, I find myself feeling just a little skeptical. It’s interesting. I understand the findings, but emotionally, it’s somehow hard to accept that less treatment/surgery is good enough. It’s easier for me to accept an research that shows that more is necessary. I guess it’s because we all feel such pressure to do everything we possibly can to beat this disease. I never want to go through all of what I did again, so I’m happy to add on something more. But doing less feels scary to me.

Don’t get me wrong, I’m elated by this research. It doesn’t matter for me, but could have such a major impact on other women in the future. It’s wonderful for them.

I just find my fear of doing less interesting. Your thoughts? I’m curious how some of you feel about this.

Julie

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8 Responses to Lymph Node Removal May Not Be Necessary In Some Breast Cancers

  1. Jody says:

    I’m all for this and have been amazed but the downside: I’ve been stunned by the number of women who were not offered SNL and had nodes removed unnecessarily. Less is more in my book.

    Unfortunately, I had no option. After four rounds of chemo I still have cancer in the sentinel nodes so consequently underwent dissection with all of the subsequent issues. And even with that, I still think that one day in the not too distant future we’ll look back on SNL as antiquated. I already am.

    Thanks for writing, as I’m so interested in finding out what others are thinking,
    jody

  2. Sandy says:

    Doing less sounds scary to me too. I had a girlfriend that supposedly had cancer in just one breast. She insisted that her doctors remove both breasts. Post surgery, cancer was found in the breast previously thought to be cancer free. I also saw my Mom suffer with severe lymphedema. I still say take no chances and get rid of everything! I want more survivors…

  3. julie says:

    This wouldn’t have mattered for me either – I had 2 tumors larger than 2cm. I do think it’s great for the future of women with this disease! If other women didn’t have to deal with all the issues I’ve had – super!

    I’m actually kind of surprised at my little bit of unease. On some emotional level it’s just hard to really grasp. Because my cancer was aggressive & I had quite a high number of positive nodes, I’ve spent a decade always looking for something more that I can do.

    The research is fantastic! Now if someone could just explain why my brain works the way it does….

  4. julie says:

    I edited this. It was 2 inches, not 2cm, or T1 or T2 tumors.
    Interesting, I don’t really think of a 2-inch tumor as “early”, but that’s the criteria.

  5. I keep thinking about the bravery of the women who agreed to be a part of this study and do less, which was against the current standard of care. I’ve had all of my nodes removed on the left side, and have developed lymphedema. But I don’t know if I would do it any differently, even knowing what I know now. I knew for sure I had it in at least 1 node before surgery, so taking them all out seemed prudent to me.

  6. Chez says:

    Julie, I have mixed feelings on the subject. This news has reached us in Australia recently. Guess I will adopt a wait and see attitude myself.

  7. julie says:

    Tonya, I was thinking the same thing! There were a lot of doctors & med. ctrs that refused to take part because they believed it was unethical – risking the lives of women. But Bravi tutti for all who took part!

    It goes so against everything that we’ve believed. It’s just hard to believe that someone who would have 8, 10, or more positive nodes would be fine leaving them in there!

    I do wonder about longer-term follow-up. The median follow-up in the study was 6.3 yrs. What about 10+ years?

    The data is strong, though. So, assuming it holds up, it really is such good news for our future breast cancer sisters!

  8. gillian says:

    I also find this fascinating. Once again, Julie, you have written a great blog posting.
    I had two cancerous lymph nodes and if I remember correctly, one was 2.5cm. I had no surgery. Lymph node removal was never discussed but a mastectomy was, initially, although I had no primary tumour ie nothing in the breast itself. Maybe lymph node removal would have been part of the op.
    In the end, had no surgery at all because the four rounds of chemo took away the cancer completely and the surgeon told me he was not going to operate. I agree that the women who participated in the study were very brave indeed.

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