Study may influence breast cancer care

Breast cancer experts, support groups and survivors are applauding new research finding that many women with early breast cancer don't require extensive lymph node removal - a standard practice for more than a hundred years.

Specialists say the study's promising survival rates should help continue a trend toward less aggressive treatment in all aspects of breast cancer care.

"This is an interesting and compelling example of progress that can be made in medicine," said Dr. Brian O'Hea, director of the Carol M. Baldwin Breast Care Center at Stony Brook University.

The study, published this week in the Journal of the American Medical Association, is expected to change the standard of care for thousands of women - those who have small tumors removed by lumpectomy, followed by radiation and chemotherapy.

Dr. Rajiv Datta, director of the cancer center at South Nassau Communities Hospital, said the research should put an end to a painful speech doctors had to make after testing patients for cancer's spread.

"We would always say, 'The good news: There was no cancer in the nodes. The bad news: We didn't have to do such an extensive test.' "

Removing multiple lymph nodes in the armpit can cause a condition called lymphedema, marked by lifelong pain and swelling in the affected arm.

Narges Rothermel, 69, of Levittown, has been dealing with chronic lymphedema and is encouraged by the study.

"Each time there's progress, I'm relieved for my daughter. I hope she doesn't have to go through what I went through," she said. "This is one more thing that might help newly diagnosed women when they weigh their options."

Caroline Mulcahy, a social worker with the Adelphi Breast Cancer Program, said the study will be a hot topic of discussion in support groups.

Some women may have difficulty understanding that "less treatment could be better treatment," she said.

"The first feeling most women express is 'I have cancer, get it out, and get it all out and as soon as possible,' " Mulcahy said.

Dr. Monica Morrow, a member of the research team that reported the findings, said preliminary results were so convincing that she and her colleagues at Memorial Sloan-Kettering Cancer Center in Manhattan ended extensive lymph node dissections months ago.

Now that patients and advocates have gotten word of the minimalistic approach, O'Hea said, they can force physicians devoted to extensive dissections to change their ways.

Some doctors, however, aren't as convinced.

Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in Manhattan, noted that the study included only women with very limited cancers - patients most likely to have the best outcomes.