NEW YORK, Feb 16 (Reuters Health) -- Use of a radioactive probe may spare breast cancer patients the unnecessary removal of axillary lymph nodes, report Italian researchers in the February 17th issue of the Journal of the National Cancer Institute.
The probe reveals the "sentinel," or first, node to receive lymph from the breast area containing the tumor. After identification, the cancer-status of this node can be tested. If it is cancer free, then axillary dissection, or removal of the other axillary lymph nodes may not be necessary, avoiding complications -- such as arm swelling that can result from lymph node removal -- and shortening hospital stays, according to the researchers.
Currently, the axillary (armpit) lymph nodes of breast cancer patients may be removed as a precautionary measure, but are often found free of cancer.
Over a 2-year period, Dr. Umberto Veronesi and colleagues at the European Institute of Oncology in Milan, Italy, used the radioactive probe technique to identify the sentinel nodes of 376 breast cancer study participants.
In nearly 99% of the patients, the radioactive technique allowed clear identification of the sentinel lymph node.
After removing the sentinel and axillary nodes of each of these patients, the researchers compared the cancer status of each sentinel node with the rest of the removed axillary nodes.
In nearly 97% of the patients, the cancer status of the sentinel node accurately predicted whether or not the axillary nodes would be free of cancer.
"Today we seem to be on the threshold of a development that may allow axillary dissection to be foregone in a large percentage of patients," Veronesi and colleagues write.
However, they add, a clinical trial is needed "to demonstrate beyond all doubt that the method is efficacious."
SOURCE: Journal of the National Cancer Institute 1999;91:368-373.
