Technique offers new options for women with breast cancer

Observer Staff

11/12/2003 12:00:00 AM

A precision cancer detection technique will help Central Michigan Community Hospital physicians destroy breast cancer earlier than ever. And spare central Michigan residents more extensive and expensive surgery in the process.

Beginning by the end of November, CMCH patients with diagnoses of breast cancer will have the option of a sentinel node biopsy as part of their treatment. The procedure will be performed collaboratively between CMCH radiologists, who will inject the radioisotope, and the general surgeons, who will then locate and remove the affected lymph nodes.

Standard procedure following surgery to remove a breast tumor calls for doctors to remove a majority of the lymph nodes from under the arm on the same side as the breast cancer to determine if the cancer has metastasized, or spread, to the lymphatic system. The nodes are dissected and analyzed for traces of cancer. Positive results usually require more treatment including chemotherapy. But up to one-fourth of women who undergo the standard lymph node dissection suffer side effects including pain, trouble using the arm and lymphedema, or swelling of the arm. Only one-third of women, however, will have cancer in the lymph nodes.

Sentinel node biopsies were developed as a way to avoid the standard underarm lymph node dissections.

The technique uses a blue dye or radioactive marker or combination of both to identify the sentinel, or first, node in a patient. The node, which is located in different areas in each person depending on the location of the tumor, absorbs the dye or marker, acting as a kind of gatekeeper to the rest of the lymph system. This allows physicians to use a radiation detector or visual inspection through tiny incisions to identify the sentinel node.

A biopsy of the sentinel node, or up to three nodes, is then performed, instead of a time-consuming biopsy of numerous lymph nodes. If the sentinel node is free of cancer, then the rest of the lymph nodes are usually also free from cancer. If the sentinel node shows signs of the cancer, then the rest of the lymph nodes can be removed and tested. Sentinel node biopsies are successful in detecting the spread of breast cancer to the rest of the lymph system in about 95 percent of cases.

Use of the sentinel node technique reduces the chances of complications from surgery from 35 percent to around 3 percent.

Not every patient with breast cancer is a candidate for the sentinel node biopsy. But for those who are, the technique offers them a way to detect and treat breast cancer as early as possible with the least amount of surgery and potential side effects.