Breast cancer is a big health issue worldwide. Some scientists and doctors from Heidelberg University Hospital, the University of Lucerne, and several cancer groups in Europe have been looking at it.
They want to figure out if patients really need to have as many lymph nodes removed during surgery as they usually do.
The Impact of Chemo Before Surgery
Before surgery, doctors often give patients chemo to shrink the size of the tumor and affected lymph nodes. This can be very helpful.
It means that during surgery, doctors might not need to take out as many lymph nodes. This could prevent patients from suffering side effects like arm swelling, also known as lymphedema.
The Process of the Study
These experts got together to work on this issue. They talked about the challenges of managing lymph nodes in early-stage breast cancer patients.
They looked at several important areas and came up with some recommendations for doctors to use.
The Problem with Current Practices
Dr. Peter Dubsky, one of the study’s leaders, pointed out a problem. Despite the benefits of chemo before surgery, too many patients are still getting full mastectomies and having all their lymph nodes removed.
Even when chemo works well to shrink the tumor and lymph nodes, doctors aren’t always taking advantage of this.
The Proposal for Fewer Lymph Node Surgeries
Dr. Dubsky and the other experts propose a different approach. They suggest that doctors should only remove a few key lymph nodes, not all of them. This would prevent problems with lymphatic drainage from the arm.
How This Could Change Clinical Practice
The experts came up with a plan for how to do this. They made a list of practical suggestions to stop unnecessary lymph node removal.
Dr. André Pfob, another expert, explained that the plan relies on good imaging and pathology reports. With these, doctors can plan better treatment strategies.
The Result of Their Conference
At a meeting, the experts agreed on many of their suggestions. They decided that in most cases, doctors should only take out a few lymph nodes.
The rest of the treatment, like radiation, chemo, or hormone therapy, should be tailored to each patient.
Monitoring the Success of the Recommendations
To see if these new recommendations work, they’ll keep track of cancer recurrence and side effects. The overall goal is to improve the quality of life for women with breast cancer.
The Final Product: The Lucerne Toolbox
They’ve called their new guidelines “The Lucerne Toolbox”. The project was sponsored by the Hirslanden Klinik St. Anna in Lucerne.
It’s not the first time they’ve done something like this. In 2021, they also published a guide on mastectomy. Now, they’re hoping their new guidelines can make a difference for breast cancer patients.
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The study was published in eClinicalMedicine.
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