Breast Cancer Surgery Has No Benefit on Some Women

Breast cancer specialists in the United Kingdom are now standing on divided ground when it comes to the removal of lymph nodes to battle breast cancer. United States scientists new study has revealed that this removal may not give benefits to some women who undergo this painful procedure that can leave enduring problems.

Some are hoping this study will bring vast alterations to the practice. A few United Kingdom groups are already using a less surgically aggressive approach. Others are issuing words of warning about the study.

The Journal of the American Medical Association has published the study in which has revealed that women with early stage breast cancer who have the standard practice of removal of the lymph nodes had shown no difference to survival rate.

This painful procedure in which could leave the woman with enduring arm swelling, stiffness and pain also had no impact on the return of the cancer.

The study had consisted of 850 women, follows a movement away from fundamental surgery in fighting breast cancer over the last few years.

Mastectomy rates are decreasing however, lymph node removal is still a steady standing practice in the United States, especially.

All participants in the clinical trail which spanned the years 1994 and 2004, had primary biopsies revealing cancer had spread to one or two closely located lymph nodes.

Random assignment was to have ten or more starting nodes removed or none at all.

Also, the women were treated with lumpectomies to remove their tumors and a commonly used form of radiation which covers the breast and underarm area. Most women also had chemotherapy, hormone treatment or received both treatments

The research was headed by Dr. Armando E. Giuliano, Director of the Margie Petersen Breast Cancer at St. John's and Chief of Science and Medicine at the John Wayne Cancer Institute at St. John's Health Center in Santa Monica, California.

Alteration of Practice

Professor Ian Ellis, cancer pathology at University of Nottingham had study this study was "very powerful" and was conducted in an superior way.

He notes this study should be practice changing but does admit UK units are very contrary. It can take more than one study to change the mind. United Kingdom physicians are a bit more conservative and they require more proof.

Professor Ellis remarked that a trail consisting of 3,000 women, fifteen years ago in Edinburgh had revealed alike outcomes. It had not managed to change the practice across the UK. He continues to note that this study does show that centers who use less aggressive therapies are correct in their methods.

Dr. Rachel Greig, senior policy officer at Breakthrough Breast Cancer Charity had remarked on the findings as "exciting" especially since they had substantiated prior results. She too had a cautious note as to how fast the practice standard would change. Noting it change the treatment for some women in the future. That is vital so that women may possibly avoid unnecessary lymph node surgery.

Professor Michael Baum, now retired breast surgeon and director of clinical trials group at University College London noted his amusement about the research. Citing that it has been acknowledged for over twenty years that leaving untreated lymph nodes that contain a tumor does not hinder long term survival. He did a positive notation add in that the study would be powerful in altering practice and would benefit the patients.

Professor Robert Mansel, professor of surgery at University of Wales College of Medicine, Cardiff, and an expert in breast cancer research had more of a negative response to this study. Mentioning it was a very questionable area with a lot of practice founded on feelings and not information.

Caution warning advised

Professor Mansel is in agreement of lymph node removal, giving credence to research on leaving them intact is inconclusive so far.

Professor Mansel is advising caution concerning the U.S. Study indicating lots of warning signs in the paper, as example the failure in recruiting as many women as they would have liked in translation meaning that the study had been "under powered". He also note that a follow up of five years was extremely short. Citing that breast cancer is a long term disease therefore, this study is only half reliable. On the other opinion side he remarks they are using the same evidence but interpreting it in a different manner. He refers to it as a "classic problem" that problem being cancer management and there is no definitive answer.

Professor Mansel notes the European trial, Amaros, which he is leading and is scheduled to publish its findings this year and would be more apt to change practice.

Much like the United States trial, Amaros takes a beginning biopsy, followed by radiotherapy to the remaining lymph nodes to see if that was enough as not to require any more surgery.

He remarks they are on the edge of acquiring more information however, there just is not enough available. Nobody is right or wrong.

He is hoping that Amaros will give the definitive answer. The practice may be changed however, it will take two or three years before a definitive answer is seen.

Most current methods for the treatment of breast cancer include surgery, radiation, chemotherapy, biological and hormone therapy.

Monoclonal Antibody is another treatment method. This method is fairly new in use. There are several of these drugs available. This treatment tries to block or stop cancer receptor sites. This method tries to prevent the cancerous cells from spreading and it sensitizes the immune system to fend off the cancer cells.

This treatment is delivered intravenously. The frequency of treatments depends on the stage of cancer and what medications you currently are receiving. This treatment can be used with other treatments such as chemotherapy or hormone therapy, it can be given strictly on its own.

This treatment has been used for advanced cases of cancer when other treatments have failed and have been shown to be effective. Certain monoclonal antibody treatments are being used on early stage cancers. Two of these medications Avastin and Herceptin have been FDA approved for monoclonal antibody treatments. Sources:

BBC News

Can Cure

Mayo Clinic