Node Biopsy for Large Breast Tumors

A new study shows that even women with large breast tumors can benefit from a less-invasive biopsy method that avoids the pain and discomfort of full armpit node removal.

Lymphatic mapping and sentinel node biopsy, the standard of care for patients with small breast cancers, can now be used to determine how far a cancer has progressed into the lymph nodes in cases of large breast tumors. This technique has not been used until now in women with large breast tumors because of lack of data proving its reliability. Researchers at the University of North Carolina at Chapel Hill School of Medicine (UNC, USA) have shown in a study of 21 patients that sentinel node biopsy, when performed before chemotherapy is given to shrink the tumor, is very reliable. The patients in the study had tumors large enough in relation to the size of the breast that the breast could not be preserved.

In sentinel node biopsy, a surgeon injects the area near the tumor with a blue dye, which follows the path that tumor cells most likely would take from the tumor to the lymph nodes. The surgeon removes only the nodes that initially absorb the dye. These are thought to be the "sentinel” nodes, the ones to which cancer cells are most likely to travel. If no cancer is found in the sentinel nodes, then no further nodes are removed.

"I think any woman diagnosed with breast cancer should ask her physician what role this technique might play in her overall treatment,” said lead author Dr. David W. Ollila, associate professor of surgery at UNC. The study's findings were reported in the September 2005 issue of the American Journal of Surgery.