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!
Laser activated gold pyramids could deliver drugs, DNA into cells without harm
24.03.2017 | Harvard John A. Paulson School of Engineering and Applied Sciences
What does congenital Zika syndrome look like?
24.03.2017 | University of California - San Diego
Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.
The results will be published on March 22 in the journal „Astronomy & Astrophysics“.
Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...
Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.
Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...
In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...
20.03.2017 | Event News
14.03.2017 | Event News
07.03.2017 | Event News
24.03.2017 | Materials Sciences
24.03.2017 | Physics and Astronomy
24.03.2017 | Physics and Astronomy