sentinel lymph node surgery

Rochester, Minn. — Which breast cancer patients need to have underarm lymph nodes removed? Mayo Clinic-led research is narrowing it down. A new study finds that not all women with lymph node-positive breast cancer treated with chemotherapy before surgery need to have all of their underarm nodes taken out. Ultrasound is a useful tool for judging before breast cancer surgery whether chemotherapy eliminated cancer from the underarm lymph nodes, the researchers found. The findings are published in the Journal of Clinical Oncology. In the past, when breast cancer was discovered to have spread to the lymph nodes under the arm, surgeons routinely removed all of them. Taking out all of those lymph nodes may cause arm swelling called lymphedema and limit the arm’s range of motion. Now, many breast cancer patients receive chemotherapy before surgery. Thanks to improvements in chemotherapy drugs and use of targeted therapy, surgeons are seeing more women whose cancer is eradicated from the lymph nodes by the time they reach the operating room, says lead author Judy C. Boughey, M.D. a breast surgeon at Mayo Clinic in Rochester. MEDIA CONTACT: Sharon Theimer, Mayo Clinic Public Affairs, 507-284-5005, Email: newsbureau@mayo.edu Journalists: Sound bites with Dr. Boughey are available in the downloads.

Most patients whose breast cancer has spread to their lymph nodes have most of the lymph nodes in their armpit area removed after chemotherapy to determine if any cancer remains. But a study conducted through the American College of Surgeons Oncology Group and led by Mayo Clinic breast surgeon, Judy Boughey, M.D., shows that a less invasive procedure known as sentinel lymph node surgery successfully identified whether cancer remained in lymph nodes in 91 percent of patients with node-positive breast cancer who received chemotherapy before their surgery. Dr. Boughey says, “Since treatment with chemotherapy before surgery can eliminate cancer in the lymph nodes in some patients, we were interested in evaluating whether sentinel lymph node surgery could successfully identify whether cancer remained in the lymph nodes after chemotherapy. Removing only a few lymph nodes reduces the risk of surgical complications such as numbness and arm swelling.” The findings are published online in The Journal of American Medical Association. Read news release. Journalists: Sound bites with Dr. Boughey and animation are available in the downloads.