Breast cancer: Radiation to lymph nodes may top surgery
June 13, 2013 | by Hiu Chung So
For breast cancer patients whose disease has spread to local lymph nodes, treatment may entail surgical removal of those nodes to decrease the likelihood of recurrence. But that procedure also comes with the risk of lymphedema, a painful swelling of the arm caused by retained fluids.
However, findings from a recent study suggest that future patients can be spared this debilitating side effect without compromising survival outcomes.
The research, presented at the American Society of Clinical Oncology's (ASCO) annual meeting earlier this month, looked more than 1,400 women with breast cancer that had spread to local lymph nodes. They were then randomly assigned to have their nodes either surgically removed or treated with radiotherapy.
The scientists reported that there were no significant differences in overall survival and disease-free survival between the two groups five years post-treatment. However, the patients who underwent radiotherapy had approximately half the risk of developing lymphedema compared to those who had surgery. One year post-treatment, 40 percent of the surgery group had developed lymphedema compared to 22 percent of the radiation group. After five years, this decreased to 28 percent for the surgery group and 14 percent for the radiation group.
“Lymphedema is a serious concern for patients and a side effect that can affect their quality of life indefinitely,” said the study’s lead author Emiel J. Rutgers, M.D., in an ASCO Post article. “I am sure these findings will lead to many doctors rethinking their strategy for treating patients who have a positive sentinel node biopsy.”
Joanne Mortimer, M.D., director of the Women’s Cancers Program at City of Hope, told HealthDay that radiotherapy for lymph nodes is already commonplace in Europe and that patients in the United States “should ask their doctors if radiation [of the lymph nodes] is a feasible option.”
Rutgers said he and his team plan to continue the study through the 10-year, and possibly 15-year, mark to assess longer-term outcome differences.