Surgery and Radiotherapy for Patients With Breast Cancer

Andrew D. Seidman, MD, a professor of medicine at the Weill Cornell Cancer Center and an attending physician at the Memorial Sloan-Kettering Cancer Center, discusses breast cancer treatment with surgery and radiotherapy.

Seidman says that a study by Dr. Emiel J. Rutgers comes at a time when the oncology community has seen that it is possible to perform less surgery without putting patients at an increased risk of lymph node recurrence under the arm or in the axilla. In this study, patients with involvement of a sentinel lymph node were randomly assigned to undergo a complete axillary lymph node dissection or axillary radiotherapy.

Clinical Pearls

The findings from this trial showed that the two approaches were equally effective in controlling breast cancer recurrence, but the radiotherapy led to substantially less swelling of the arm and hand (lymphedema) 1 year and 5 years afterward. Seidman says this represents a new option for patients.

• Less surgery does not equate to an increased risk of lymph node recurrence
• In a trial, complete axillary lymph node dissection and axillary radiotherapy were equally effective in controlling breast cancer recurrence