New procedure to reduce surgery for 20,000 breast cancer patients a year
Around 20,000 women a year could be spared invasive surgery under a new early-stage breast cancer procedure that is to be adopted across the NHS after a new study, the ALMANAC trial, found it to be safe and reliable.
The procedure will also reduce the time patients have to spend in hospital following surgery from five days to two.
Currently in the UK, patients undergoing surgery for early-stage breast cancer usually have the twenty or so lymph nodes in their armpit removed for testing, to see if the cancer has spread.
However, lymph node removal can cause a number of unpleasant side effects, such as decreased arm and shoulder function.
The new procedure, known as sentinel node biopsy, involves removing and examining only the first gland - known as the sentinel node - that leads from the breast.
Until the current trial, conducted by a team headed by professor Robert Mansel of Cardiff University, there had been doubts over the reliability of the approach.
The authors found that sentinel lymph node biopsy was associated with better arm function, better quality of life, a shorter hospital stay, and faster recommencement of daily activities than standard lymph node dissection.
In addition, women who underwent a sentinel lymph node biopsy had a low recurrence rate of cancer and had survival rates equivalent to those of women in the standard treatment group.
"New surgical techniques and better reconstruction have helped women enormously with the physical and psychological side-effects of breast cancer treatment," said Professor Lesley Fallowfield of Cancer Research UK, who worked on the trial.
"But most still have to contend with the long lasting physical side-effects of surgery to the armpit.
"Sentinel node biopsy is an enormous advantage in these cases and this study shows it can improve the patients' quality of life when performed by carefully trained surgeons," she added.
The trial was judged to be so successful that it was brought to an early conclusion to allow all participants to have the new treatment.
The research is published in the Journal of the National Cancer Institute.