Follow-up lymph node dissection may not be necessary for breast cancer patients with negative sentinel node biopsy

Sometimes the first time’s a charm, at least when it comes to breast cancer biopsies. According to a study published in the New England Journal of Medicine, extensive lymph node dissections, used to detect breast cancer cells following an initial sentinel lymph node (SLN) biopsy, may not be necessary if the SLN biopsy is found to be negative. Researchers from the University of Vermont found that after following up with 616 breast cancer patients who had “occult” or micrometastases as compared to over 3,000 patients with no cancer cells, the five year survival rates of those who received follow-up lymph node dissections were only 1.2 percent lower than those who did not.

ACSH's Dr. Gilbert Ross cited the summary when he said that the main point of this study is that “the extensive pursuit of tiny pieces of cancer in such patients is not worth the effort.” The lead author, Dr. Donald Weaver of the Vermont Cancer Center, said “There is an impact on outcomes, but it's so small that it's not worth looking for micrometastases, and you should not change clinical management based on their presence.”

Dr. Ross summarized thusly: “Clinically, women who have had surgery for breast cancer and a negative or minimal finding on SLN biopsy need not undergo complete lymph node dissection, which can lead to complications including persistent lymphedema (swelling) of the arm.”