More aggressive breast cancer surgery may not offer a survival advantage. Surgeons have been removing lymph nodes from the armpit since the earliest days of radical mastectomy a century ago. The idea was to catch any cancer cells before they escaped and caused metastases elsewhere in the body. It also gave oncologists an opportunity to assess whether the disease was still confined to the breast.
A new study throws this widespread practice into question for early-stage breast cancer. Nearly 900 women participated in the trial. All had lumpectomy to remove the tumor. Then they were randomized to have at least 10 lymph nodes removed or no further surgery. Lymph node removal carries risks such as swelling, nerve damage or infection. The six-year survival for both groups of women was not significantly different.
[JAMA, Feb. 9, 2011]