Claim: Breast-cancer study questions lymph node removal
Verdict: SUPPORTS

Retrieved passages:
title: Breast cancer management
text: the lymph nodes in the axilla are also considered for removal. In the past, large axillary operations took out 10 to 40 nodes to establish whether cancer had spread. This had the unfortunate side effect of frequently causing lymphedema of the arm on the same side, as the removal of this many lymph nodes affected lymphatic drainage. More recently, the technique of sentinel lymph node (SLN) dissection has become popular, as it requires the removal of far fewer lymph nodes, resulting in fewer side effects while achieving the same 10-year survival as its predecessor. The sentinel lymph node is the

title: Axillary lymph nodes
text: the nodes. For clinical stages I and II breast cancer, axillary lymph node dissection should only be performed after first attempting sentinel node biopsy. If cancer cells are found in the nodes it increases the risk of metastatic breast cancer. Another method of determining breast cancer spread is to perform an endoscopic axillary sentinel node biopsy. This involves injecting a dye into the breast lump and seeing which node it first spread to (the sentinel node). This node is then removed and examined. If there is no cancer present, it is assumed the cancer has not spread to the other

title: Bernard Fisher (scientist)
text: the lymph nodes prior to metastatic spread and, therefore, required radical surgery to remove the entire breast, underlying chest muscle, and axillary lymph nodes to halt metastasis.” For over ten years, Fisher and his research team carried out “a multitude of investigations regarding the biology of tumor metastasis.” Their findings caused them to question the very theories upon which Halsted's approach had been based, and led them to formulate an alternative hypothesis. This was “that breast cancer was a systemic disease in that tumor cells were likely to have been disseminated throughout the body by the time of diagnosis and

title: Breast cancer
text: tissue. One or more lymph nodes may be biopsied during the surgery; increasingly the lymph node sampling is performed by a sentinel lymph node biopsy. Standard surgeries include: Once the tumor has been removed, if the person desires, breast reconstruction surgery, a type of plastic surgery, may then be performed to improve the aesthetic appearance of the treated site. Alternatively, women use breast prostheses to simulate a breast under clothing, or choose a flat chest. Nipple prosthesis can be used at any time following the mastectomy. Drugs used after and in addition to surgery are called adjuvant therapy. Chemotherapy or

title: Lumpectomy
text: very close to the margin. Sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) may be used to determine if the cancer has progressed away from the breast and into other parts of the body. Sentinel lymph node biopsy is the analysis of a few removed sentinel nodes for the presence of cancerous cells. A radioactive substance is used to dye the sentinel nodes for easy identification and removal. If cancer is detected in the sentinel node then further treatment is needed. Axillary node dissection involves the excision of lymph nodes connected to the tumor by the armpit

title: Lymphadenectomy
text: by Donald Morton and others. Cancer with various primary sites (breast, melanoma, colorectal, etc.) often metastasize early to the first drainage lymphatic basin. This process is predictable anatomically according to the primary site in the organ and the lymphatic channels. The first nodes (sentinel nodes) can be identified by particulate markers such as lymphazurin, methylene blue, India ink and radio-labelled colloid protein particles injected near the tumor site. The draining sentinel node can then be found by the surgeon and excised for verification by the pathologist if tumor cells are present, and often these tumor cells are few and only

title: Lymphadenectomy
text: easily recognized by careful examination or by using techniques such as special stains, i.e. immunohistochemical. When the sentinel node is free of tumor cells, this is highly predictive of freedom from metastasis in the entire lymphatic basin, thus allowing a full node dissection to be avoided. The practice of sentinel lymph node mapping has changed the surgical approach in many cancer systems, sparing a formal lymph node dissection for patients with sentinel lymph node negative for tumor and directing a full node dissection for patients with sentinel lymph node positive for tumor metastases. For example in stage II breast carcinoma,

title: Lumpectomy
text: therapy" was a real possibility. After a lumpectomy is performed for DCIS, local radiation therapy is typically performed to help eliminate microscopic-level disease. Axillary sentinel lymph node biopsy, as a method of screening for metastatic disease in otherwise non-invasive DCIS, is falling out of favor because the risks of procedure outweigh any effect on outcomes. For DCIS, chemotherapy is not recommended, but tamoxifen may be recommended for tumors which contain an abundance of estrogen receptors. For patients with invasive ductal carcinoma who have lumpectomies, lymph node biopsy and radiation therapy are usually recommended. Adjuvant chemotherapy is often recommended, but it

title: Micrometastasis
text: Therefore, adjuvant chemotherapy and adjuvant radiation therapy are more effective to eliminate micrometastases, since they are aimed to target dividing and quiescent cells. Adjuvant therapies are administered after the removal of the lymph nodes. The significance of these therapies is to serve as a “clean up” method for those cells that have migrated elsewhere from the primary tumor. It is still in question by researchers whether this treatment method to rid the body of this small cluster of cells that may or may not progress is worth the side effects that it may cause. Side effects include fatigue, hair loss,

title: Lymphadenectomy
text: differentiated thyroid cancer, breast cancer, lung cancer, gastric cancer and colorectal cancer. Famed British surgeon Berkeley Moynihan once remarked that "the surgery of cancer is not the surgery of organs; it is the surgery of the lymphatic system". The better-known examples of lymphadenectomy are "axillary lymph node dissection" for breast cancer; "radical neck dissection" for head and neck cancer and thyroid cancer; "D2 lymphadenectomy" for gastric cancer; and "total mesorectal excision" for rectal cancer. For clinical stages I and II breast cancer, axillary lymph node dissection should only be performed after first attempting sentinel node biopsy. Sentinel node biopsy can

title: Micrometastasis
text: different number of lymph nodes in her body, so determining how many nodes to remove is not based on location, rather than number. The lymph nodes serve as a filtering system for the lymphatic system, so it is important to preserve as many as possible, while also ridding the body of all cancer cells. In order to eliminate micrometastases that are not near lymph nodes and have traveled to distant regions of the body, chemotherapy and radiation therapies are necessary. However, since most micrometastatic tumor cells are in the nonproliferative G0 phase, standard cytotoxic chemotherapies may not be as useful.

title: Lymphadenectomy
text: using the sentinel lymph node technique, 65% of patients could be spared from a formal node dissection. Lymphedema may result from lymphadenectomy. Extensive resection of lymphatic tissue can lead to the formation of a lymphocele. Lymphadenectomy Lymphadenectomy or lymph node dissection is the surgical removal of one or more groups of lymph nodes. It is almost always performed as part of the surgical management of cancer. In a regional lymph node dissection, some of the lymph nodes in the tumor area are removed; in a radical lymph node dissection, most or all of the lymph nodes in the tumor area

title: Invasive carcinoma of no special type
text: lymph nodes is a good indication that the cancer has not spread systemically. Presence of cancer in the lymph nodes indicates the cancer may have spread. In studies, some women have had presence of cancer in the lymph nodes, were not treated with chemotherapy, and still did not have a systemic spread. Therefore, lymph node involvement is not a positive predictor of spread. Tumor size staging and node involvement staging can be combined into a single clinical staging number. The appearance of cancer cells under a microscope is another predictor of systemic spread. The more different the cancer cells look

title: Breast cancer management
text: (removal of the lump only), a mastectomy, or a modified radical mastectomy. Lymph nodes are often included in the scope of breast tumor removal. Surgery can be performed before or after receiving systemic therapy. Lumpectomy techniques are increasingly utilized for breast-conservation cancer surgery. Studies indicate that for patients with a single tumor smaller than 4 cm, a lumpectomy with negative surgical margins may be as effective as a mastectomy. Prior to a lumpectomy, a needle-localization of the lesion with placement of a guidewire may be performed, sometimes by an interventional radiologist if the area being removed was detected by mammography

title: Lymphadenectomy
text: Lymphadenectomy Lymphadenectomy or lymph node dissection is the surgical removal of one or more groups of lymph nodes. It is almost always performed as part of the surgical management of cancer. In a regional lymph node dissection, some of the lymph nodes in the tumor area are removed; in a radical lymph node dissection, most or all of the lymph nodes in the tumor area are removed. It is usually done because many types of cancer have a marked tendency to produce lymph node metastasis early in their natural history. This is particularly true of melanoma, head and neck cancer,

title: Breast cancer awareness
text: of lymph nodes during mastectomy, the more limited approach of sentinel node biopsy was developed. Advocacy efforts also led to the formal recommendation against the routine use of the Halsted radical mastectomy in favor of simple mastectomies and lumpectomies . The breast cancer movement has supported practical, educational, emotional, and financial care for women with breast cancer. Support groups, individual counseling opportunities, and other resources are made available to patients. Supporting breast cancer was seen as a distinctively pro-woman stance popular among public official. This has resulted in better access to care. For example, in much of the United States,

title: Paget's disease of the breast
text: 85% and 80% respectively, with adjuvant chemotherapy even 95% and 90%. If there is a palpable mass, it is 32% and 31% respectively, with adjuvant chemotherapy (40% and 35%). Positive lymph-nodes have been positively associated with a palpable mass and affect the prognosis to be now just 28% survival after 10 years (vs 79% without palpable mass and without affected lymph-nodes). Involvement of the lymph nodes does not directly cause any harm, but is merely an indicator of systemic spread. Furthermore, patients with an identifiable associated underlying breast tumor have a survival rate of 38-40% at five years and a

title: Breast
text: central axillary lymph nodes and to the apical axillary lymph nodes. The lymphatic drainage of the breasts is especially relevant to oncology because breast cancer is common to the mammary gland, and cancer cells can metastasize (break away) from a tumour and be dispersed to other parts of the body by means of the lymphatic system. The morphologic variations in the size, shape, volume, tissue density, pectoral locale, and spacing of the breasts determine their natural shape, appearance, and position on a woman's chest. Breast size and other characteristics do not predict the fat-to-milk-gland ratio or the potential for the

title: Lymph node
text: rapid enlargement over days or weeks. Lymphoma is managed by haematologists and oncologists Local cancer in many parts of the body can cause lymph nodes to enlarge, usually because of tumours cells that have metastasised into the node. Lymph node involvement is often a key part in the diagnosis and treatment of cancer, acting as "sentinels" of local disease, incorporated into TNM staging and other cancer staging systems. As part of the investigations or workup for cancer, lymph nodes may be imaged or even surgically removed. Whether lymph nodes are affected will affect the stage of the cancer and overall

title: Lymphangiosarcoma
text: relatively common complication of the massive lymphedema of the arm which followed removal of axillary (arm pit) lymph nodes and lymphatic channels as part of the classical Halstedian radical mastectomy, as a treatment for breast cancer. The classical radical mastectomy was abandoned in most areas of the world in the late 1960s to early 1970s, being replaced by the much more conservative modified radical mastectomy and, more recently, by segmental breast tissue excision and radiation therapy. Because of this change in clinical practice lymphedema is now a rarity following breast cancer treatment—and post-mastectomy lymphangiosarcoma is now vanishingly rare. When it