Seriously?

cookiegal

"The trial included more than 5,600 patients with no clinically apparent axillary node metastasis randomized to sentinel node dissection alone or with axillary node dissection."

I realize this may have happened a few years ago, and a lot has changed in the two years I have been involved with this.

I also have the utmost respect for anyone who is in a clinical trial.

But my god the idea of randomizing node negative women to axillary dissection seems brutal!

kira66715

Cookie, do you have a link to the abstract?

I'm not sure then they had to "prove" that SNB was as sensitive as ALND in detecting nodal disease, but I imagine when ALND was the standard of care, this was how the studies were performed.

And now we have the Giuliano study showing if only 1-2 nodes positive, no increased survival with ALND.

Kira

cookiegal

I actualy read it on BCO a few minutes ago! It was in one of those breaking news boxes, but I can't find my way back. You are right, 5 or 10 years ago, it might have seemed more reasonable.

http://www.breastcancer.org/treatment/surgery/new_research/20110909.jsp

kira66715

Cookie, I'll try and find the published article, but it looks like a press release of data from the National Breast and Bowel study.

Wow.

Over 5000 women with clinically negative nodes randomized to SNB or ALND.

The false negative rate for SNB was 15%, but it clinically made no difference if the other nodes weren't removed.

http://www.breastcancer.org/treatment/surgery/new_research/20110909.jsp

This is the study that gave us breast conservation and oncotype dx, and it's been going on for almost 30 years, so I have to figure out when they did this part of it.

My MIL, who died of other causes last year at 85, was diagnosed at 49 with bc, and as she lived in Pittsburgh, where this study was started, by the Fischers, was ofered randomization into breast conservation vs. mx, and felt uncomfortable with breast conservation.

When I first visited their house, there was this large hook over their bed--my FIL put it there for my MIL to drain the LE from her arm while she read in bed..... 

Kira

cookiegal

I mean it's easy to stand here and look back and say WTF?

You are right the studies made huge contributions.

It's so interesting, even two years ago I was the only node positive who opted out of chemo in sight and in site..and now it's common thanks to a study.

kira66715

Cookie, let's just figure out if they were randomizing these women within the last few years, or decades ago--it makes a difference.

sushanna1

Not sure about this study but in 2001, I was offered a SNB but only if it was followed by an Axillary node dissection as part of an on-going trial.  Since I went into my cancer experience wanting to avoid lymphedema, I ended up commuting a couple of hours to a major cancer center that offered SNB.  Unfortunately I had a positive node so ended up with the axillary node dissection (and lymphedema) anyway.  Sigh.