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Less is More For Lymph Node Removal: February 5, 2014

It frequently fell into the category of unintended consequences. In an effort to aggressively combat breast cancer, women were losing lymph nodes. That often resulted in a loss of quality of life. Surgeons are now rethinking the practice.

“I think we’re getting more and more away from lymph nodes, which really creates a lot of side effects, a lot of complications with lymphedema,” says Dr. Rie Aihara, surgical oncologist on Lee Memorial Health System’s medical staff.

It was not uncommon for women to find themselves battling lymphedema, a life-long swelling that occurs when fewer lymph nodes are available to distribute lymphatic fluid. Many also required post-op therapies to alleviate severe pain and reduced range of motion.

“There’s a lot of scaring involved and limited range of motion in usually the shoulder and sometimes the neck and thoracic region.  A lot of times they cannot reach into cabinets or do their hair. Sometimes they actually need someone to help them with showering,” says Pat Curr, Lee Memorial Health System physical therapist.

Comprehensive studies were done to find out if lymph node removal was necessary to treat invasive breast cancer. The conclusion was ‘no’ years ago surgeons removed 20 to 30 lymph nodes from armpit, now it’s believed that less is more.

“If there were cancer cells regardless of how big the deposits were, we used to remove all the lymph nodes. But with this new data- a group of women who had these lymph nodes that were positive who went on to axillary node dissection vs. those that didn’t and the conclusion was there really were no difference. It just added risk,” says Dr. Aihara.

It’s a conservative approach to breast cancer, that’s leaving women cancer-free and clear of a major complication.