As breast cancer research continues to advance, so too does our understanding of which treatments are more effective, and best suited to eliminating breast cancer quickly and with as little pain as possible. Now, a new study has turned one of the foundations of breast cancer care on its head, by suggesting that the invasive procedure of surgically removing all cancerous lymph nodes in the armpit may sometimes be medically unnecessary. The medical malpractice attorneys of Passen & Powell are intrigued by this study, and hope it is one of many looking for the most effective course of treatment for breast cancer.
The study was funded by The National Cancer Institute, and was conducted by a team of researchers led by Dr. Monica Morrow, chief of the breast service at Manhattan’s Memorial Sloan-Kettering Cancer Center. It was published by the peer-reviewed Journal of the American Medical Association (JAMA).
The study found disease-free survival rates nearly identical among women who have cancerous nodes removed compared with those who did not. Indeed, over the long term, the study found disease-free survival rates were actually slightly higher for those women who do not have their cancerous lymph nodes removed.
This new study may profoundly impact the way in which breast cancer is treated, as it undercuts what has been one of the keystones of breast cancer treatment for a century. Still, this is only one study of many in the field of cancer research.
The practice of removing cancerous lymph nodes is based upon a belief that the procedure could prevent the disease from returning, or spreading. This, in turn, would grant the patient a longer life. Nor is this theory without basis: research has shown that once breast cancer invades the lymph nodes, there is a possibility that it will spread further, even to vital organs. Once that occurs, surgery may no longer be a viable option.
But the procedure also has drawbacks. It can lead to complications, from the mild – treatable infections – to the severe – chronic swelling in the arm that can even cause disability. And depending on the other elements of treatment, up to half of women who undergo the procedure develop lymphedema, which may be alleviated by physical therapy, but cannot be cured. Moreover, the procedure itself and the recovery from that procedure is extremely painful.
Breast cancer patients in whom cancerous lymph nodes have been identified are now nearly uniformly treated with chemotherapy and radiation. Indeed, it would likely constitute medical negligence for a physician to forgo such treatments. As it happens, these treatments may be sufficient to eliminate the cancer in the lymph nodes, as well.
Fortunately, the new research identifies criteria that doctors can use to determine which patients are good candidates for lymph node removal, and which are not. For example, the findings only apply to those whose tumors were early stage (less than two inches across).
These criteria apply to about twenty percent of breast cancer patients. Although this is less than one quarter of patients, this corresponds to about 40,000 women each year in the United States alone who can be spared this painful and dangerous procedure.
Some in the medical community have already begun to adjust their practice to account for this new information. For example, Manhattan’s Memorial Sloan-Kettering Cancer Center has already adjusted its treatment policies for women with cancerous nodes. Still, the idea that cancerous lymph nodes must be removed has been such an integral part of treatment for so many decades, experts such as the Chicago medical malpractice lawyers of Passen & Powell believe that it will be many more years before doctors nationwide truly begin to change.
In the meantime, women whose physicians advise lymph node removal should discuss this new research with their doctor, and ensure that he or she is acting in accord with the latest developments. Your physician may not yet be aware of the study, or may be skeptical, but you can take charge of your own care and insist upon up-to-date information and treatment.
For a free consultation with an experienced Chicago medical malpractice attorney at Passen & Powell, call us at (312) 527-4500.
