SNAC 3 years
Sentinel-lymph-node biopsy reduces arm swelling after breast cancer surgery
New results from the SNAC trial show that women
with early breast cancer who have a sentinel-lymph-node procedure
have less subsequent arm swelling over 3 years than women who have
the older, more invasive clearance of lymph nodes.
Removal of the majority of nodes had been the
standard way of detecting spread of cancer cells, but this has
risks, including arm swelling, pain, and movement limitation, which
can last for many years.
The SNAC trial was conducted as a response to the
patients' complaints and comments about these symptoms. Breast
surgeons from the Royal Australasian College of Surgeons in
collaboration with the CTC trialled the new form of surgery:
injecting dye into the tumour, tracking the movement of the dye and
removing only the first armpit lymph node where the dye was seen
(the sentinel node). If there was no tumour in that node, the
surgeon concluded that the cancer had not spread.
1088 women with early breast cancer in Australia
and New Zealand entered the trial. Half had sentinel-lymph-node
based management and half had routine axillary clearance.
The patients have since had regular arm
measurements and assessments and have provided information on their
quality of life. Although the benefit of the sentinel-lymph-node
operation for arm swelling was still apparent, by 3 years the
groups were the same for other symptoms such as arm movement.
Patients are still being followed up, and the
analysis of 5 years of data will soon be published. The
investigators have also been recruiting women with larger tumours
and multiple tumours for the SNAC2 trial. They aim is to find out
whether the risk of cancer recurrence is the same after
sentinel-node biopsy as after full node clearance. If so, the
sentinel-node procedure will become standard practice for all women
with early breast cancer.
View the article here
For more information: SNAC@ctc.usyd.edu.au
22 October 2014