Less Is More When It Comes To Surgery
Recent Blog Entries From Dr. Dave Hnida
Often women with early stage breast cancer have the tumor removed, but also have the lymph nodes removed underneath the armpit. Why? Mainly because this is the way we’ve been doing it for a century.
And here’s why that’s a problem: not all of the lymph nodes need to be removed. And removing them doesn’t make for an easy surgery, or more importantly, a comfortable life after surgery.
Many women who have those lymph nodes removed (because of the fear they all contain cancer cells) wind up having lifelong side effects from the surgery. Since the circulation of the arm gets messed up, there’s often burning, numbness, swelling, and pain all the way from the shoulder to the hand. It’s a miserable side effect to breast cancer surgery.
But now a study in JAMA says “not-so-fast.” You don’t need to have all of the lymph nodes removed.
Researchers followed about 800 women with breast cancer who either had all of the lymph nodes removed, or just a few. The “just a few ” group had the same survival rate as the women who had more radical surgery — without the complications. The key was the doctors only removed the ones that contained microscopic cancer cells (there’s a way to determine this before removal.) And if the nodes have no cancer — and often most don’t — they aren’t removed.
It all means we doctors need to get with the times and offer women this lesser surgical option.
The key thing to remember is, yes, breast cancer is a terrifying diagnosis. But it is not an emergency. You have time for a second opinion. And you have certainly should be told whether or not a less radical surgery may be an option for you.
Most women survive breast cancer. Now its time to make sure they don’t suffer the side effects of overly aggressive surgeons.
Please ask questions. Bring a friend or family member to your visit and take the time to get info from organizations such as the American Cancer Society. Then make the decision that’s right for you.