Lymphatic mapping and sentinel node biopsy, when used to determine how far the cancer has progressed into the lymph nodes, can help some patients avoid the pain and discomfort of full armpit node removal, which often causes swelling, numbness and infection.
The surgical technique hasn't been used until now in women with large breast tumours because of a lack of data proving its reliability. But the new study from the University of North Carolina at Chapel Hill School of Medicine may provide that research evidence.
The findings show that sentinel node biopsy, when performed before chemotherapy is given to shrink the tumour, is very reliable, the UNC researchers said. The study suggests that sentinel node biopsy is an option that might benefit all women with breast cancers, said Dr. David W. Ollila, associate professor of surgery at UNC.
“Our study indicates that women with large breast cancers can derive a benefit from the sentinel node technology just like women with small breast cancers,” Ollila added.
Subjects in the study were 21 breast cancer patients with tumours large enough in relation to the size of the breast that the breast could not be preserved. Before neoadjuvant chemotherapy, the researchers performed sentinel node biopsy, modifying the technique slightly for larger cancers by using a larger volume of dye and more injections.
If the procedure showed disease in the sentinel node or if the tumour was larger than five centimeters, all the axillary nodes were removed, and the patient received chemotherapy and surgery. If the biopsy showed tumour-free sentinel nodes, and the tumour was less than five centimetres in diameter, no further lymph nodes were removed and the patient received chemotherapy and tumour removal.
In an average of 36 months of post-treatment follow-up, none of the patients showed progression of cancer in the lymph nodes. The sentinel node biopsy accurately predicted node involvement, with a false negative rate of 0 percent, Ollila said.
MEDICA.de; Source: University of North Carolina