Posted on June 18th, 2013 by
For women with early-stage breast cancer and a positive sentinel lymph node, use of radiation—rather than surgery—to treat the axillary lymph nodes appears to be effective and to have a lower risk of lymphedema. These results were presented at the 2013 Annual Meeting of the American Society of Clinical Oncology (ASCO).
For women with early breast cancer, determining whether the cancer has spread to the axillary (under the arm) lymph nodes is an important part of cancer staging. Evaluation of the axillary nodes often involves a sentinel lymph node biopsy. The sentinel nodes are the first lymph nodes to which cancer is likely to spread. If the sentinel nodes contain cancer, women often undergo more extensive lymph node surgery (axillary lymph node dissection). A common side effect of axillary lymph node surgery is lymphedema of the arm—swelling of the arm due to an accumulation of lymph fluid.
To evaluate a different approach to treating the axillary lymph nodes, researchers in Europe conducted a Phase III clinical trial (the AMAROS trial). The study included 1,425 women with early-stage breast cancer and a positive sentinel lymph node (a sentinel lymph node that contained cancer). Women underwent additional lymph node treatment with either surgery or radiation therapy.
This study suggests that radiation therapy to the lymph nodes may be an alternative to lymph node surgery for selected women with early-stage breast cancer. The two treatment approaches appear to have similar effectiveness, but radiation therapy may be less likely to cause lymphedema.
Reference: Rutgers EJ, Donker M, Straver ME et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer patients: final analysis of the EORTC AMAROS trial (10981/22023). Presented at the 49th Annual Meeting of the American Society of Clinical Oncology. May 31-June 4, 2013; Chicago, IL. Abstract LBA1001.
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