2023-10-16 08:07:47
by Paolo Veronesi
Until a few years ago, the sentinel lymph node was removed and analyzed to decide whether or not to remove the other lymph nodes as well. Today we know that axillary dissection is not necessary even in the case of one or two positive lymph nodes
The mammogram found a one-centimeter nodule: are there alternatives to the sentinel lymph node in the diagnosis of breast cancer? They told me about ultrasound: effective?
Answered by Paolo Veronesi, director of the Senology Program, European Institute of Oncology, Milan (VAI AL FORUM)
The sentinel lymph node technique is a milestone in the history of breast cancer and today a standard technique to check whether tumor cells have reached the axillary lymph nodes and are therefore at risk of spreading to other organs. In fact, lymph nodes are small organs along the lymphatic pathways located in the neck, armpits, groin or abdomen, which have the task of filtering substances that travel through the lymphatic fluid, helping the body to fight infections and the diseases. Until a few years ago, even in small tumors that were candidates for conservative surgery, the sentinel lymph node was removed and analyzed to decide whether or not to also remove the other lymph nodes.
Lymph node biopsy
In this way, axillary emptying was avoided when unnecessary, saving possible unwanted consequences: first of all lymphedema or swollen arm which causes pain and difficulty in moving freely. A few years ago, thanks to an American study, we have seen that, for the safety of the patient, it is not necessary to continue with axillary dissection even in the case of one or two positive sentinel lymph nodes. At IEO we have taken a further step forward, designing and coordinating a multicenter study to evaluate whether it is possible to also avoid sentinel lymph node biopsy in small tumors. The research, which involved more than 1,400 women, was published in the journal Jama Oncology and confirmed our hypothesis that sentinel lymph node biopsy in early tumors does not provide us with information that can modify postoperative therapies and improve recovery.
Examination lasting a few minutes
Naturally provided that the lymph nodes are studied not only with the clinical examination but also with an accurate ultrasound, to exclude the presence of gross metastatic involvement. The exam is neither painful nor dangerous, lasts a few minutes and is simple to perform. After applying a small quantity of gel to the skin, the specialist places the ultrasound probe by moving it over the part under examination: only particular attention is needed on the part of the person performing it to make sure that there are no metastases. The advantages are evident, because the surgery is even less invasive and the costs for our National Health Service decrease.
October 16, 2023 (modified October 16, 2023 | 08:06)
© ALL RIGHTS RESERVED
#Breast #cancer #sentinel #lymph #node #biopsy #time.news