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Some Breast Cancer Patients May Not Need Node Dissection

Some Breast Cancer Patients May Not Need Node Dissection

BERN, Switzerland--A study of 1,619 breast cancer patients has identified a population subset with a very low incidence of lymph node metastases in whom axillary lymph node dissection might be omitted, Andreas Barth, MD, told Oncology News International.

This series of patients was comprised of those with T1-T4 breast cancer who underwent level I/II axillary dissection between 1979 and 1995 at The Breast Center, Van Nuys, Calif. Analysis of 11 clinical/pathological factors showed that patients with nonpalpable, non-high grade tumors of less than 10 mm, with no lymph-vascular space involvement had an incidence of lymph node metastases of only 3%.

"In these patients, a lymph node dissection could be omitted, especially if they are postmenopausal and ER positive," said Dr. Barth, of the Institute of Medical Oncology, Bern, Switzerland. Dr. Barth worked on the study under Dr. Melvin Silverstein during a fellowship at Van Nuys, and presented the data at the San Antonio Breast Cancer Symposium.

He pointed out that this population subset comprises only about 7% of all breast cancer patients, "so it doesn't solve the problem for about 93%, and that's where newer techniques, like the sentinel lymph node biopsy, might come in."

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