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Research Shows Tailored Treatment Can Save Breast Cancer Patients from Extensive Lymph Node Removal.
A recent study presented at the 14th European Breast Cancer Conference reveals promising findings for breast cancer patients facing lymph node involvement. Led by Dr. Annemiek Van Hemert from the Antoni van Leeuwenhoek-Netherlands Cancer Institute (AVL-NKI) in Amsterdam, the research suggests that tailored treatments may allow patients to avoid extensive lymph node removal, thus reducing the risk of complications.
Dr. Van Hemert explained, "We aimed to predict treatment response by assessing just one lymph node. This approach could spare patients from debilitating complications like lymphoedema."
The study, conducted between 2014 and 2021, involved 218 patients with breast cancer that had spread to the lymph nodes. Utilising the MARI protocol (marking axillary lymph nodes with radioactive iodine seeds), the researchers monitored cancer outcomes over four years. The protocol, developed in 2014, focuses on assessing cancer spread using FDG-PET/CT scans and tailoring treatment accordingly.
Patients underwent primary systemic treatment, including chemotherapy or targeted therapies, followed by surgery. If the marked lymph node showed no residual tumor cells post-treatment, no additional nodes were removed. Patients with the remaining tumour cells underwent further lymph node removal.
Results revealed that patients achieving a pathological complete response (pCR) in the marked node experienced low rates of cancer recurrence (2.9%) and high overall survival (95%) after 44 months. Conversely, patients requiring additional node removal had slightly higher recurrence rates (3.5%) but still demonstrated favourable survival outcomes (90%).
Dr. Van Hemert emphasised the importance of this approach, particularly in light of advancements in primary systemic treatment. Despite improved treatment response rates, unnecessary lymph node removals persisted. She hopes that these findings will encourage clinicians to adopt de-escalation strategies, benefiting a larger cohort of breast cancer patients.
The researchers plan to gather more long-term data and are conducting the DESCARTES trial to explore radiation treatment omission in select patients. Dr. Fiorita Poulakaki, co-chair of the conference and Head of Breast Surgery at Athens Medical Centre Hospital, Greece, commented on the significance of minimising treatment-related harm and improving survivorship for breast cancer patients.
These findings mark a significant step towards personalised breast cancer care, offering hope for improved outcomes and quality of life for patients worldwide.
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