According to new research findings, many early breast cancer patients won’t have to have the painful lymph node removal surgery that has, for over a century, been routine. This was because the women in the study had chemotherapy and radiation, which most likely removed disease from the nodes, despite the previous assumption that once these nodes are cancerous, they have the potential to spread to vital organs and can only be removed by surgery.
According to the new results, does not improve the patient’s chance of survival or decrease the likelihood that the cancer will return. And the surgery has significant complications, like infection and lymphedema, a chronic swelling in the arm. It’s not clear, though, whether the results are the same for women who don’t have chemotherapy or radiation.
The study is especially newsworthy because it should change medical practice for many patients. And it may take a while for doctors and patients to adjust to the idea that surgery is not the best option. “This is such a radical change in thought that it’s been hard for many people to get their heads around it,” said Dr. Monica Morrow, one of the study’s authors. According to her, people find it easier to accept the idea of more treatment instead of less, even if the data supports decreased intervention.
In the New York Times, Denise Grady points out the recent trend toward less invasive treatments for breast cancer; mastectomy rates have dropped since the 1980′s, and doctors now remove large, dense tumors while using radiation to destroy smaller traces of the disease.
Although it’s good that doctors are responding well to the new research, this is a reminder that medical authority is not infallible. That’s why it’s so crucial that studies like this continue, and that we don’t unquestioningly accept doctors’ advice. One study co-author admitted that, by removing large numbers of nodes, “I have a feeling we’ve been doing a lot of harm.” And it does seem that if women have been having these surgeries unnecessarily, they suffered through infection and lymphedema, in addition to chemotherapy and radiation, for nothing. But we can’t expect medicine to be perfect. And so in that sense, a study like this is ultimately encouraging, if it means that women in the future will be spared a painful surgery.
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