Breast Cancer Patients May be Spared Additional Surgery
NorthShore University HealthSystem Researcher reports in the Journal of Clinical Oncology.
Evanston, IL (Vocus) May 20, 2009
A recent study in the Journal of Clinical Oncology, authored by David J. Winchester (http://www. northshore. org/apps/findadoctor/doctor. aspx? docid=566&lid=1789), FACS, M. D., Chief of General Surgery and Surgical Oncology, NorthShore University HealthSystem, concludes that women whose breast cancer (http://www. northshore. org/clinicalservices/cancer/cancerspecialties/breast/default. aspx) has spread to the lymph nodes may not need a radical lymph node surgery.
The observational study of more than 97,000 women whose breast cancer spread to the lymph nodes indicates that women with microscopic lymph node metastases detected on sentinel lymph node (SLN) biopsy, shared the same benefit and survival rate as those who underwent a SLN biopsy with a more invasive completion axillary lymph node dissection (ALND). The analysis was conducted using the National Cancer Database of the American College of Surgeons and was published in the Journal of Clinical Oncology, May 2009.
Dr. Winchester, along with the other study authors, analyzed data from approximately 1,400 hospitals. The women whose breast cancer cases were analyzed underwent SLN biopsy for clinically node-negative breast cancer from 1998 to 2005 and were found to have nodal metastases. The authors report that some patients with lymph node metastases identified on sentinel node biopsy may not need to have the rest of their lymph nodes removed.
"The surgical community now has confirmed evidence to demonstrate there is no need for aggressive surgery if limited microscopic breast cancers are detected," said Dr. Winchester. "Treating cancer is as much about improving quality of life for our patients as it is about long-term survival."
We have relied upon that operation too much, and this paper points out we may not need to do it in terms of a survival difference or a regional recurrence difference, Winchester explained. This is an operation associated with significant morbidity. Among the morbidities linked to ALND are a lifetime risk of lymphedema (http://www. northshore. org/clinicalservices/pmr/), problematic cosmetic outcomes, longer recovery times and more postoperative pain than SLN biopsy alone.
The National Cancer Data Base, which is a joint program supported by the American College of Surgeons Commission on Cancer and the American Cancer Society, is recognized as the largest clinical registry in the world. It is a nationwide oncology outcomes database for more than 1,460 Commission on Cancer accredited cancer programs in the United States and Puerto Rico, and captures approximately 70 percent of all new invasive cancers diagnosed annually.
About NorthShore University HealthSystem
Headquartered in Evanston, Ill., NorthShore University HealthSystem (NorthShore) is a comprehensive, fully integrated, healthcare delivery system that serves the greater North Shore and northern Illinois communities. The system includes four Hospitals - Evanston Hospital, Glenbrook Hospital, Highland Park Hospital and Skokie Hospital. In addition, the health system has more than 2,400 affiliated physicians, including a 600-physician, multispecialty physician group practice with over 70 office locations - NorthShore University HealthSystem Medical Group. Further, NorthShore is committed to excellence in its academic mission and supports teaching and research as the principal teaching affiliate for the University of Chicago Pritzker School of Medicine.
The NorthShore University HealthSystem Research Institute focuses on clinical and translational research, including leadership in outcomes research and clinical trials. The NorthShore University HealthSystem Foundation is a leading philanthropic entity of NorthShore. It raises charitable contributions, engages volunteer friends and invests in community partnerships.
NorthShore has annual revenues of $1.5 billion and a staff of more than 8,000. The HealthSystem has significant capabilities in a wide spectrum of clinical programs, including cancer, heart, orthopaedics, high-risk maternity and pediatrics. NorthShore is a national leader in the implementation of innovative technologies, including electronic medical records, (EMR ). In 2003, the HealthSystem was among the first in the country to successfully launch a systemwide EMR with demonstrable benefits in quality, safety, efficiency and service to patients. NorthShore has been recognized by multiple national organizations for this notable achievement.
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