Moore also reports that some women having whole-breast radiation are able to cut their course of treatment from six weeks down to three weeks, and that, among women having a mastectomy (total breast removal), fewer women need full axillary node dissection
(meaning fewer lymph nodes are removed).
Axillary node dissection
no longer standard of care.
She had a right mastectomy and right axillary node dissection
The use of closed suction drain after lumpectomy and axillary node dissection
for breast cancer.
INTRODUCTION: Breast conserving treatment (BCT), including primary tumor excision, axillary node dissection
(Determined in advance or decided following sentinel node sampling) and external beam radiation treatment (RT) and chemotherapy to the breast, is considered standard of care for women with early-stage breast cancer in most countries.
Roberge is known nationally for her work in physical therapy for patients who have undergone axillary node dissection
and/or treatment for breast cancer.
For women with no suspicious axillary nodes who undergo breast-conserving therapy, there is little evidence of benefit in doing a complete axillary node dissection
compared with sentinel node biopsy alone, the reviewers report.
British surgeon Charles Hewitt Moore advised mastectomy with complete axillary node dissection
and chest wall muscles in the 1860s but it was William Halsted who made the concept of a radical mastectomy a practice in the 1880s.
Arm edema was more common after lumpectomy plus axillary node dissection
than after lumpectomy alone.
In the American College of Surgeons Oncology Group's Z0011 trial, survival was nearly identical between women who underwent lumpectomy and sentinel node dissection alone, followed by adjuvant chemotherapy and tangential-field whole-breast irradiation, and women who underwent axillary node dissection
when sentinel node biopsy revealed limited metastasis, followed by the same chemotherapy and irradiation.
Axillary node dissection
is slowly going out of favour for women with early breast cancer because of accumulating evidence that looking for metastases beyond sentinel lymph nodes does more harm than good.
These subjects were randomly assigned to undergo standard axillary node dissection
(445 patients) or no axillary node dissection
(446 patients), followed by whole-breast tangential-field radiation (not third-field nodal irradiation) and whatever adjuvant systemic therapy their treating physicians deemed necessary.