Harvard Women's Health Watch

What's new in early breast cancer treatment?

It may be time to rethink traditional lymph node removal and radiation.

Studies released in 2010 include several that may lead to changes in at least two areas of early breast cancer treatment.

Limited lymph node removal

Removing lymph nodes in the armpit (axilla) is a common part of breast cancer treatment, because it provides a way to find out if cancer has spread beyond the breast. The lymph nodes are a logical first place to look, because they filter lymph fluid from the breast. Today, sentinel lymph node biopsy — removing and checking only the lymph node or nodes closest to the breast — is the standard of care. If no cancer cells are found in the sentinel node(s), no more nodes are removed. But if cancer is found, axillary lymph-node dissection, which removes, on average, 10 to 15 additional lymph nodes, is usually performed. This procedure can cause pain, numbness, and swelling (lymphedema) in the affected arm but has been thought necessary, to determine the extent of node involvement and plan treatment.

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