The current standard for all forms of breast cancer is sentinel node dissection to determine if the cancer has spread to the lymph nodes. Immediately before surgery, doctors inject dye into the tumor and trace its route. It will go first to the sentinel node. The dye highlights that node, which is removed, along with one or two surrounding nodes, which are all tested for cancer. If the cancer has spread to that node, the patient will have a full axillary lymph node dissection, or removal of all cancerous nodes.
However, according to a phase 3 clinical trial recently published in JAMA (2011), women with tumors smaller than 2 centimeters with affected lymph nodes who had surgery to remove the nodes had nearly identical survival statistics as those who did not have the nodes removed.
This was true no matter the hormone status of the tumor, so it would be true of triple-negative. Researchers clarify that this does not apply to women who are at a high risk for reoccurrence such as those with three or more positive sentinel lymph nodes, larger tumors, or those who received preoperative chemotherapy.
Five-year survival rates were were 92.5 percent for those with no additional surgery and 91.8 percent for those with axillary lymph node dissection, a difference that researchers say is not statistically significant.
Doctors say this research may be a game changer, leading to fewer removals of the lymph nodes, a surgery that can lead to lymphedema and limited range of motion.
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