"New" procedure for lymph node testing....

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Tavish
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Date Joined Jul 2003
Total Posts : 2272
   Posted 2/6/2005 7:00 PM (GMT -7)   
I was looking at U of M's website to see what is new, before my visit next week.  I came across an article from late November, about a new and promising way to evaluate lymph nodes using ultrasound and a fine needle biopsy for some women.
 
I did not recall hearing about this last year, just wanted to share.  I posted the link and the article.  Too late for us to benefit, but new procedures are always exciting.
 
 
Ultrasound-guided biopsy lets some women avoid additional surgery

added 11/29/04

Ann Arbor -A key question after a cancer diagnosis is whether the cancer has spread to nearby lymph nodes. Researchers at the University of Michigan Comprehensive Cancer Center have found a new non-surgical technique that can help doctors determine when breast cancer has invaded the lymph nodes, sparing some women an extra trip to the operating room.

The technique, which uses ultrasound along with a fine needle biopsy, is a reliable way of determining whether the lymph nodes are malignant, according to research results being presented Monday, Nov. 29, at the Radiological Society of North America’s annual meeting in Chicago.

Traditional ways of determining cancer’s spread to the axilla, or underarm, are sentinel lymph node sampling, in which the first lymph node is identified and assessed for cancerous cells, or axillary lymph node dissection, in which all the lymph nodes in the underarm are removed and examined for cancer. If the sentinel node biopsy shows cancer, then a patient needs to return to the operating room to have the lymph nodes removed.

For some women, chemotherapy may be necessary before surgery, in which case, doctors must determine whether the lymph nodes are affected before the chemotherapy begins. Rather than undergo a sentinel lymph node sampling surgery, doctors can use ultrasound-guided fine needle aspiration to confirm the cancer’s spread without surgery.

“The goal of the study was to use ultrasound to pre-operatively assess the axillary lymph nodes. If we can use ultrasound to stage the axilla and identify metastatic disease, we can save some women the additional surgery,” says Alexis Nees, M.D., clinical assistant professor of Radiology at the U-M Medical School. Nees will present the results at the RSNA meeting.

The technique uses ultrasound to identify the axillary lymph nodes and determine if their appearance is normal or abnormal. If they look abnormal, a small 22-gauge needle is inserted into the node to extract cells that can be evaluated for cancer. It requires only local anesthesia and involves no surgical incisions. Both sentinel lymph node sampling and axillary node dissection are full surgical procedures.

The researchers used ultrasound to examine 57 women newly diagnosed with breast cancer. If the lymph nodes appeared abnormal on the ultrasound, the researchers performed a fine needle aspiration, using ultrasound to guide the biopsy. Patients then had breast surgery and either sentinel lymph node sampling or axillary node dissection.

Pathology reports from surgery were compared to results from the ultrasound-guided fine needle aspiration. Of the women whose ultrasound showed abnormal lymph nodes, 92.8 percent had cancerous nodes at surgery. And, the researchers found, all the women with an abnormal ultrasound and a positive biopsy were found to have cancer in their lymph nodes at surgery.

“Both those numbers are extremely high,” says Nees. “This tells us that axillary ultrasound combined with ultrasound guided fine needle aspiration of abnormal lymph nodes can identify some patients with cancer in their lymph nodes. These patients can proceed with chemotherapy or definitive surgery and be spared an additional surgical procedure.”

Nees notes the technique is not reliable to rule out the cancer’s spread; it can only confirm positive lymph nodes. Because of that, if the test comes back negative, sentinel lymph node sampling would still be necessary. The U-M Comprehensive Cancer Center offers the ultrasound and fine needle biopsy to all appropriate patients.

In addition to Nees, study authors are Mark Helvie, M.D., professor of Radiology and director of the Breast Imaging Division; Stephanie Patterson, M.D., assistant professor of Radiology; Marilyn Roubidoux, M.D., associate professor of Radiology; and Lisa Newman, M.D., associate professor of Surgery and director of the Comprehensive Cancer Center’s Breast Care Center.

For information about breast cancer, visit Breast Cancer Information or call the Cancer AnswerLine at (800) 865-1125.



Cathi
Veteran Member


Date Joined Jul 2003
Total Posts : 702
   Posted 2/7/2005 2:16 PM (GMT -7)   
Hi Lori

Thanks for the info...that really sounds promising. As it said one less trip to the OR
would be good.

L & H

Cathi
Sometimes it is a slender thread, Sometimes a strong,
stout rope; She clings to one end, I the other;
She calls it friendship; I call it hope....


gma
Veteran Member


Date Joined Jul 2003
Total Posts : 2921
   Posted 2/7/2005 6:09 PM (GMT -7)   
Always great to hear of less invasive measures of testing. Sometimes the test is worse than the results. I had all my nodes removed and later learning my cancer was so early and primary stage I think I could certainly have gotten away without having any removed. Thank goodness so far I have had no lymphedema problems. Hugs MK


Luci
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Date Joined Jul 2003
Total Posts : 892
   Posted 2/7/2005 8:08 PM (GMT -7)   
Well, there was a time when drs. didn't do sentinel node bx very often. Now it's more the norm rather than the exception. This new procedure seems like it's on the same path. Anything that's less invasive and still reliable is welcome. Thanks for sharing this one, Hugs, Luci
In the depth of winter, I finally learned that within me lay an invincible summer.  Albert Camus


BMarie
New Member


Date Joined Feb 2005
Total Posts : 15
   Posted 2/7/2005 10:22 PM (GMT -7)   
I am a patient at Breast Cancer Center at U of M and just had this ultrasound guided needle biopsy. It was done in less than 30 min. I hope to have my results back by Wednesday. I will let you know the results. Dr. N said if it was negative, I of course would need to have the sentinel node biopsy.

BMarie
New Member


Date Joined Feb 2005
Total Posts : 15
   Posted 2/11/2005 5:42 PM (GMT -7)   
Well, my test came back negative, although this does not rule out that the cancer has spread to the nodes. Based on this information, my surgeon feels that I am a candidate for immediate reconstruction and that makes me happy today.

God Bless and Take care.

Tavish
Veteran Member


Date Joined Jul 2003
Total Posts : 2272
   Posted 2/11/2005 7:27 PM (GMT -7)   
YEA! Great news! Negative is one of our favorite words here! So glad for you and thanks for sharing!

Lori

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