Health News about Breast Cancer Biopsy



May 5, 2005 -- Research confirms newest breast cancer biopsy technique is accurate, Safe. Leading pathology expert says Sentinel Node Biopsy reduces risks, delivers comparable results

Three separate studies recently confirmed that Sentinel Node Biopsy (SNB) - the newest technique used to establish staging information for women diagnosed with breast cancer - is as accurate at pinpointing spread of the disease as traditional axillary biopsies, and may be appropriate for many more women than those for whom it's currently being prescribed.

According to Dr. George Hollenberg, M.D., a leading NY-area pathologist and founding director of Acupath Laboratories, these findings are critical to increasing quality of life for early-stage breast cancer patients. "One of the first things a woman who has been diagnosed with breast cancer must face is the axillary biopsy," Dr. Hollenberg explains. "Before SNB, this process was highly invasive, and involved the removal of up to 30 or more lymph nodes from under the arms. Recovery time was lengthy, and surgical drains were needed, sometimes for as long as two weeks after the procedure." In addition, Dr. Hollenberg points out that up to 10% of women undergoing the traditional axillary node biopsies report chronic numbness or pain in the arms or hands as a result of the procedure.

Despite SNB's promise, concerns about accuracy have plagued the technique for several years. However, a study in the January 2005 issue of the Annals of Surgical Oncology followed 874 patients for 27 months, and found that Sentinel Node Biopsy "provides an accurate measure of axillary disease," and that recurrence in the nodes following SNB was "extaordinarily rare." A second study in the same journal noted that axillary recurrence following a negative SNB finding occurred at approximately the same rate as that of traditional node biopsies. And a third study, published in the April 20, 2005 Journal of Clinical Oncology, finds that women who have already had chemotherapy for their breast cancer - currently considered poor candidates for SNB - are as likely as those who have not had previous treatment to receive an accurate diagnosis through SNB.

The node biopsy process is necessary, Dr. Hollenberg explains, because it is the best indicator of whether or not the cancer has spread beyond the breast. "We have learned that breast cancer cells in most cases migrate through the lymph system before metastasizing elsewhere in the body," he says. "If we do not find cancer cells in the lymph nodes, we can be confident that the disease is localized, or Stage I," he adds. If cancer is present in the lymph nodes, then the patient might undergo further node removal and biopsy, CAT scans, MRI or other diagnostic tests to establish the extent of the disease involvement.

The benefit of Sentinel Node Biopsy is that it allows physicians and pathologists to discover whether the cancer has spread without examining the entire lymph system. By "mapping" the axillary lymph nodes using radioactive dyes, doctors can find the "sentinel," or first, node in the chain and remove only that one in a less invasive surgical procedure. Surgical drains are rarely needed, healing time is much speedier, and long-term negative effects of the procedure are less common.

"It's always been clear that SNB is much easier on the patient," Dr. Hollenberg says. "But the questions over accuracy in the SNB technique have traditionally focused on the identification of that 'Sentinel,' or primary, node," he adds. "If it were misidentified and a false negative diagnosis were made, the patient might not receive the treatment protocol that was best for her. This is why the current studies are such good news for the overall diagnosis and treatment of breast cancer, both for the patient and for the medical practitioners involved."

About Dr. George Hollenberg
Dr. George Hollenberg, M.D. is an authority in the fields of pathology, clinical pathology and dermatopathology with expertise in the areas of dysplastic nevi, melanoma, prostate and gastrointestinal cancer. Board-certified in Pathology and Dermatopathology, Dr. Hollenberg is a Fellow of the College of American Pathologists, The American Society of Dermatopathology and the AMA. He has published articles on skin, prostate and gastrointestinal cancer, and is the Consultant in Dermatopathology to The North Shore University Hospital Center. As the founding director of Acupath Laboratories, Inc., Dr. Hollenberg supervises the analysis of tens of thousands of biopsies per year, using the latest cutting-edge technology in histology and immunocytochemistry, as well as the latest advances in computerized report preparation.





Health News about Breast Cancer Biopsy