Some Breast Cancer Patients May Not Need Node Dissection

BERN, Switzerland--A study of 1,619 breast cancer patients has identifieda population subset with a very low incidence of lymph node metastasesin whom axillary lymph node dissection might be omitted, Andreas Barth,MD, told Oncology News International.

This series of patients was comprised of those with T1-T4 breast cancerwho underwent level I/II axillary dissection between 1979 and 1995 at TheBreast Center, Van Nuys, Calif. Analysis of 11 clinical/pathological factorsshowed that patients with nonpalpable, non-high grade tumors of less than10 mm, with no lymph-vascular space involvement had an incidence of lymphnode metastases of only 3%.

"In these patients, a lymph node dissection could be omitted, especiallyif they are postmenopausal and ER positive," said Dr. Barth, of theInstitute of Medical Oncology, Bern, Switzerland. Dr. Barth worked on thestudy under Dr. Melvin Silverstein during a fellowship at Van Nuys, andpresented the data at the San Antonio Breast Cancer Symposium.

He pointed out that this population subset comprises only about 7% ofall breast cancer patients, "so it doesn't solve the problem for about93%, and that's where newer techniques, like the sentinel lymph node biopsy,might come in."