Less invasive biopsy to detect metastasis found suitable for more patients.

2002 OCT 24 - (NewsRx.com & NewsRx.net) -- New data support expanding the pool of women with breast cancer who are potential candidates for sentinel node biopsy (SNB), a less-invasive procedure to determine whether the disease has spread to the lymph nodes, according to interim results from an ongoing clinical trial reported at the recent "Era of Hope" U.S. Department of Defense Breast Cancer Research Program meeting.

The study also provides early indications that the type of test conducted on the SNB sample may enhance the accuracy of the results.

"SNB has dramatically better benefits than axillary node dissection because it is less invasive and more accurate at finding whether the tumor has spread," said Lorraine Tafra, MD, director of the Breast Center at the Anne Arundel Medical Center in Annapolis, MD. "This and other multicenter studies have shown that the surgeon's experience with the procedure is critical. Now we're investigating the role of other factors that might widen the applicability of the technique and further improve reliability."

SNB is replacing axillary node dissection as the procedure of choice to determine whether cancer has migrated beyond the breast for recently diagnosed patients. With axillary dissection, 10-30 lymph nodes under the arm next to the affected breast are removed in a procedure that involves surgery around nerves and the nearby major vein. The rate of complications, primarily fluid collection, infection, and loss of sensation in the arm, can be as high as 25-50%. However, only a few of these axillary lymph nodes actually drain from the breast and are appropriate first-line indicators of metastatic disease. Most women have one or two such "sentinel" nodes.

With SNB, the surgeon injects one or more agents around the tumor, which then travel through the lymphatic pipes, highlighting the lymph nodes most likely to contain metastatic disease; no major nerves or vessels are disturbed. If the sentinel node does not contain cancer cells, the chance of the disease being in the remaining lymph nodes should be very small, explained Tafra.

In this study, scientists compared biopsy results from more than 1200 patients who had SNB, the majority of whom also then had the standard axillary node dissection procedure, to see whether they could identify any patient-specific ...