The biopsy Sentinel lymph nodes This is a surgery in which the first lymph node that the cancer can reach from the original tumor is removed to analyze whether it contains cancer cells.
Normally, This procedure helps to know if he Breast cancer was Spread to the lymph nodes. However, there is increasing evidence that normal-appearing lymph nodes are useful for prognosis and rarely interfere with overall treatment.
A phase III clinical trial presented on the Breast Cancer Symposium Saint Anthony des American Association for Cancer Researchsuggested that omission of sentinel lymph node biopsy in a group of women with early-stage breast cancer had no effect on disease control or survival after five years of follow-up.
It is aimed at the group of sick women without suspicious lumps and with HR-positive and HER2-negative tumors.
“Breast cancer treatment has evolved into less invasive surgery without sacrificing oncological safety,” he explained. Marjolein SmidtDoctor and professor at the Medical Center Maastricht University from the Netherlands.
He explained that the biopsy is performed to classify the armpit, but “it mainly provides information about prognosis and rarely changes the decision about systemic treatment in the absence of cancer in the nodes.”
The study included 1,733 women with tumors up to five centimeters in size and lymph nodes that showed no signs of cancer based on physical exams, pre-surgery ultrasounds and tissue analysis when necessary.
All received conservative surgery and radiotherapy and were randomly divided into two groups: one with sentinel lymph node biopsy and the other without.
After an average follow-up of five years (in 1,574 evaluable patients), the results were similar in both groups: In 0.5% of those who received a biopsy and in 1.2% of those who did not receive a biopsy, the cancer recurred in the nodes near the tumora difference that had no statistical significance.
Furthermore, the Five-year regional recurrence-free survival was 96.6% with biopsy and 94.2% without biopsy.
According to Smidt, “These results show that sentinel lymph node biopsy could be avoided, particularly in patients with HR-positive and HER2-negative early tumors, as this type was the most common in the study (86.6%).”
The biopsy may cause discomfort, scarring, and in some cases lymphedema (swelling in the arm due to fluid buildup), which may require treatment with physical therapy.
The scientist emphasized this Skipping surgery is cost-effective, speeds recovery, and avoids complications. which, according to patients, leads to a better quality of life. Regarding the use of Hormone therapywas indicated in 48.6% of patients who received a biopsy and in 46.6% of patients who did not undergo a biopsy.
Smidt warned: “Hormonal therapy can have a major impact on quality of life and should be carefully analyzed before it is indicated.”
Although it was used less frequently than in other similar studies, the risk of relapse remained low; However, patients should continue monitoring as late relapses are possible.
The researchers also recognized limitations in the study. Complete five-year follow-up could not be performed on all participants, and only whole breast radiotherapy was studied after conservative surgery.
Smidt cautioned that there is no guarantee that this strategy is as safe as other radiation therapies, although the results could be applied in the future following further studies.
These data relate primarily to HR-positive and HER2-negative tumors up to two centimeters in size, as women with larger tumors or other subtypes of breast cancer were less represented in the study.
The study was funded by the Dutch Cancer Society, Central health insurance and the Netherlands Organization for Health Research and Development.
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