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Lymph Node Study Shakes Pillar of Breast Cancer Care

February 21, 2011 | 55,819 views

Breast CancerA new study has shown that many women with early breast cancer do not actually benefit from the removal of armpit lymph nodes, a painful procedure that has been routine practice for 100 years.

For about 20 percent of patients, removing the nodes has no advantage -- it neither improves survival nor makes the cancer less likely to recur. What's more, the procedure can cause complications such as infection and lymphedema.

According to the New York Times:

"Experts say that the new findings, combined with similar ones from earlier studies, should change medical practice for many patients. Some centers have already acted on the new information ... But more widespread change may take time, experts say, because the belief in removing nodes is so deeply ingrained."

In separate news, the U.S. Food and Drug Administration (FDA), after an intensive review of known cases of anaplastic large cell lymphoma (ALCL) in breast implant recipients, has issued a statement warning that women with implants may have an increased risk of developing the cancer.

FDA and the American Society of Plastic Surgeons are working together to establish a registry of ALCL patients who have breast implants. FDA scientists hope the registry provides enough information to better understand the risks.

According to the FDA:

"In the cases reported, ALCL was typically diagnosed years after the implant surgery. In most of these cases, the women were diagnosed after they observed changes in the look or feel of the area surrounding the implant."


Dr. Mercola's Comments:

Removing lymph nodes from under the arms of breast cancer patients -- a surgery that's been done for 100 years -- may be causing more harm than good, doing nothing to improve survival rates or keep cancer from recurring, while increasing the risks of serious complications.

Researchers found that in about 20 percent of patients, which amounts to about 40,000 women a year, removing lymph nodes was unnecessary and instead increased risks of infection and lymphedema, a swelling in the arm that can become disabling.

Important Information for Women With Breast Cancer

This new revelation challenges one of the pillars of breast cancer care in the United States, and while some medical centers have already changed their procedures based on these results, widespread acceptance in the medical community is likely to take far more time.

As it stands, the standard treatment for breast cancer patients whose cancer has spread to the sentinel lymph node is to surgically remove the other nodes as well -- a procedure called axillary node dissection. (The "sentinel node" refers to the node closest to the tumor, or the lymph node that can be reached by metastasizing cancer cells first.)

However, studies have shown that this invasive procedure has virtually no impact on survival or disease recurrence, while frequently causing additional pain and debilitation.

After five years, 82.2 percent of the women who had the axillary nodes removed were still alive and in remission, compared to 83.9 percent of the women who did not get the operation.

If you or someone you love has breast cancer, please share this information with them and urge them to find out if they meet the criteria that would make them better off NOT having their lymph nodes removed. This includes:

  • Tumors were detected early, at stage T1 or T2 (less than two inches across)
  • Biopsies had detected cancer in armpit nodes, but nodes were not large enough to be felt during an exam
  • Cancer had not spread anywhere else in the body
  • Women had received lumpectomies, and most had also received radiation, chemotherapy, hormone-blocking drugs or a combination

This finding adds to emerging research showing that many standard treatments in breast cancer care may actually not be the most advantageous.

In the past several months alone, a number of studies have been published in which the conclusion was that conventional treatments are not having the beneficial impact previously thought, suggesting we need to limit the use of certain treatments to get better results.

More Revelations That Challenge Breast Cancer Standards of Care

In addition to the removal of lymph nodes, current conventional treatment also typically includes chemotherapy and radiation therapy.

For example, chemo is a standard recommendation for women whose cancer has spread to the lymph nodes, despite its magnificent failure rate and oftentimes lethal side effects.

Similarly, six or more weeks of radiation is also part of the standard treatment for most women with breast cancer. However, according to another recent study, just ONE dose of radiation, delivered with precision to the affected site directly after her lumpectomy, had the same rate of effectiveness as the extended radiation treatment!

Many practitioners are also still advising their patients to avoid exercise during and after cancer treatment. But Harvard Medical School researchers found patients who exercise moderately -- 3-5 hours a week -- reduce their odds of dying from breast cancer by about half as compared to sedentary women.

In fact, any amount of weekly exercise increased a patient's odds of surviving breast cancer. This benefit also remained constant regardless of whether women were diagnosed early on or after their cancer had spread. So the outdated advice to avoid exercise during cancer treatment is actually causing cancer patients harm, as regular exercise can lead to a number of health improvements.

Breast Implants May Increase Your Risk of Cancer

In other breast health news that is challenging the status quo, the FDA has issued a consumer update for women who have, or are considering, breast implants, warning them of a potential increased risk of anaplastic large cell lymphoma (ALCL), a rare type of non-Hodgkin lymphoma, a type of cancer that involves cells of your immune system.

The update was released after an FDA review of scientific literature published from January 1997 through May 2010 revealed 34 unique cases of ALCL in women with breast implants worldwide.

The FDA's adverse event reporting systems also have had 17 reports of ALCL in women with breast implants, and, after consulting with other regulatory authorities, scientific experts, and breast implant manufacturers, approximately 60 reports of ALCL in women with breast implants have been reported worldwide.

Though this may seem like a small number, it is significant given the rarity of the disease. Only about one in 500,000 cases of ALCL are diagnosed in women in the United States each year, according to the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute, and ALCL in the breast is found even less often, in only three in 100 million U.S. women per year.

As the FDA reported:

"Although the total number of ALCL cases in women with breast implants is extremely low, it is higher than would be expected from the SEER data alone. Furthermore, these cases seem to follow fairly consistent patterns, including the close proximity of the ALCL to the breast implants and the type of tumor pathology.

Because of this, the FDA believes that women with breast implants may have a very small but increased risk of developing ALCL in the scar capsule adjacent to the implant."

The FDA is now collaborating with the American Society of Plastic Surgeons to establish a registry of ALCL cases in women with breast implants in order to gather more information.

In the United States, breast augmentation was the most popular cosmetic surgical procedure in 2010, with over 296,000 surgeries last year alone, a 39 percent increase from 2000. Worldwide, it's estimated that between 5 million and 10 million women have breast implants, to give you an idea of just how common this surgery has become.

However, obviously its prevalence should not lull you into a false sense of security, even as the U.S. FDA and other regulatory agencies continue to claim breast implants are safe.

Other Breast Implant Risks You Should Know

If you or someone you love is considering breast augmentation, you should be aware that this is a major surgery that comes with serious risks -- and given that it is typically an elective cosmetic procedure, you've got to weigh whether these risks are worth it.

As the FDA reports, risks of breast implants include:

  • Reoperations (additional surgeries), with or without removal of the device
  • Capsular contracture (hardening of the area around the implant)
  • Breast pain
  • Changes in nipple and breast sensation
  • Rupture with deflation for saline-filled implants
  • Rupture with or without symptoms for silicone gel-filled implants
  • Migration of silicone gel for silicone gel-filled breast implants
  • May impact your ability to breast feed by reducing or eliminating milk production

You should know, too, that breast implants do not last forever. Most breast implants rupture over time, due to damage during implantation, folding or wrinkling of the implant, or trauma or other excessive force to the breast (including the compression that occurs during mammography).

This means that you should expect to have additional breast surgeries during your lifetime and, according to the FDA, your risk of complications increases when you have your implants replaced, compared to the first surgery.

Further, rupture is one of the greatest risks of silicone implants, as they are known for "silent ruptures" that leak silicone into your system without your ever knowing it. The silicone in the implants is not benign. Rather, it is a complex chemical that can have very significant and devastating consequences on your immune system, along with being linked to connective tissue disorders.

Because of the high risk of silent rupture, women with silicone implants are advised to get an MRI three years after the initial surgery and then every two years thereafter to check for potential rupture -- and this can get very expensive.

As the FDA notes:

"Over your lifetime, the cost of MRI screening may exceed the cost of your initial surgery. This cost may not be covered by medical insurance."

So, given the risks and the costs involved, before you consider breast implants it's certainly worth a reminder that typically any consideration of breast implants is a sign of a deeper issue, namely a poor-self-image. Often this can be addressed very safely and effectively using the Emotional Freedom Technique (EFT) to remove your negative emotions and replace them with positive ones.

More Tips for Breast Health and Breast Cancer Prevention

As the ALCL-breast implant risk continues to be explored, it's also worth noting that this will probably not be the last time that a new breast implant surgery risk is uncovered.

Case in point, as discussed above it was just revealed that removing lymph nodes from under the arms of breast cancer patients may be causing more harm than good.

The point is, anytime you surgically alter a part of your body there will be consequences, some of them likely unknown, so it's important to weigh the benefits versus the risks, especially when the procedure is an elective one, as most breast augmentations are.

And when it comes to breast cancer, which currently strikes about one out of every eight women, remember that the current medical paradigm is virtually clueless about its causes and how to effectively treat it. Most conventional cancer treatments actually add insult to injury by doing more harm than good -- a fact that up to this point has been swept under the rug by the medical industry.

When dealing with cancer, it's important that you work with a health care practitioner who is truly knowledgeable about the underlying causes of the disease in order to help you best heal and recover.

That said, if you have breast implants or otherwise are interested in reducing your risk of cancer, a healthy diet, regular physical exercise, appropriate sun exposure and an effective way to manage your emotional health are the cornerstones of just about any cancer prevention program.

For more details specifically about breast cancer prevention, read my article Beating Breast Cancer: A Guide to Prevention, Treatment and Recovery.

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