Axillary lymph node dissection is done in conjunction with lumpectomy or mastectomy to determine if breast cancer has spread to the adjoining lymph nodes. The conventional surgical approach leaves a surgical scar that is unattractive and can restrict range of motion in the shoulder joint.
Also, squeezing and pulling the tumor during the breast operation can stimulate tumor cell metastases. A new study in the December issue of Mayo Clinic Proceedings reports that an endoscopic technique, mastoscopic axillary lymph node dissection (MALND), can reduce these complications.
"Patients who undergo MALND experience improved operative outcomes, fewer complications, better functional conservation, and more attractive cosmetic results," says lead investigator Chengyu Luo, MD, of Fuxing Hospital, Capital Medical University, Beijing, China. "When performed by a well-trained surgeon, it is the treatment of choice."
1027 patients with operable breast cancer were randomly assigned to one of two study groups. The first group underwent a breast operation and axillary lymph node dissection by conventional surgical means (CALND). The second group first underwent MALND and then conventional breast surgery. Both groups were treated post-operatively with systemic therapy and radiation therapy. The patients were followed for 63 months.
The average blood loss in the MALND group was lower than that in the CALND group. There was no significant difference between the two groups with respect to operative time. The patients who underwent MALND had less axillary pain, numbness, paresthesias and arm swelling. The aesthetic appearance of the axilla was much better in the MALND group than in the CALND group.
No statistically significant difference in disease free survival or overall survival between the two groups was observed. However, there was a significant difference between the two groups in the distant metastasis rate in favor of the MALND group. "This is the most significant finding of the study," says Dr. Luo.
"While there is not as yet any significant difference in survival, longer term follow-up (e.g., 10 years and 20 years) is still needed to make a definitive conclusion. This may suggest that the axillary operation should be done before the breast operation even in conventional surgery."
Rachael Zaleski | EurekAlert!
Researchers identify new way to unmask melanoma cells to the immune system
17.01.2018 | Duke University Medical Center
Study advances gene therapy for glaucoma
17.01.2018 | University of Wisconsin-Madison
What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...
For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.
Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...
At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.
No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...
Scientists at Tokyo Institute of Technology (Tokyo Tech) and Tohoku University have developed high-quality GFO epitaxial films and systematically investigated their ferroelectric and ferromagnetic properties. They also demonstrated the room-temperature magnetocapacitance effects of these GFO thin films.
Multiferroic materials show magnetically driven ferroelectricity. They are attracting increasing attention because of their fascinating properties such as...
The oceans are the largest global heat reservoir. As a result of man-made global warming, the temperature in the global climate system increases; around 90% of...
08.01.2018 | Event News
11.12.2017 | Event News
08.12.2017 | Event News
18.01.2018 | Life Sciences
18.01.2018 | Life Sciences
18.01.2018 | Earth Sciences