Reporting Dr. Maria Simbra
PITTSBURGH (KDKA) – Public defender Rebecca Hudock had just turned 30 when she found breast cancer.
“I just happened to be taking a shower and felt this weird lump,” she describes. “During the initial sonogram, they immediately rolled into the biopsy. By the time I was diagnosed I was stage 3B, and there was significant lymph node involvement.”
She could feel the lumps under her arm, swollen with tumor.
She had chemotherapy before surgery.
“During the course of chemotherapy, not only did the breast lump shrink, significantly, but so did the lymph node involvement,” she says.
Doctors can remove lymph nodes in the armpit and look at the tissue under the microscope to check for spread. This helps with prognosis. They can take just the first few. This is called a sentinel node biopsy.
The question in these cases where chemo shrinks the tumors is whether doing a sentinel node biopsy is as accurate at removing all of them to check for cancer.
Hudock entered a clinical trial.
“One of the doctors came in to tell me that all of my lymph nodes were negative at that point,” she says.
The issue with removing all of them is sometimes women will have arm swelling as a later complication.
A recent study in the Journal of the American Medical Association showed that the sentinel node biopsy was actually wrong 12 and a half percent of the time when doctors went on to look at all the lymph nodes under the arm. This was worse than the cut off the researchers established at 10 percent, based on other studies looking at chemo after surgery.
But the news isn’t all bad. For certain carefully selected women, with additional techniques, Allegheny General Hospital breast surgeon Dr. Thomas Julian says the number can approach 10 percent.
“This is a great big first step in the right direction, and it will improve as surgeons become more comfortable using this technology in this patient group,” he says.
Hudock is glad she participated in the study, regardless of the outcome.
“I felt some amount of responsibility towards other women,” she says. “Because you can raise all the money that you want for breast cancer. If you can’t try out these procedures, and you can’t try out the new medications on people, all that money will go to waste.”