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Patrick I. Borgen, MD, chairman of surgery, director of the Breast Cancer Program, Maimonides Medical Center, discusses axillary node dissection in patients with early-stage breast cancer.
Patrick I. Borgen, MD, chairman of surgery, director of the Breast Cancer Program, Maimonides Medical Center, discusses axillary node dissection in patients with early-stage breast cancer.
It has always taken time for change to be realized in the cancer space, Borgen says. Specifically, minimizing the removal of healthy lymph nodes in women with breast cancer has taken time. Borgen says that surgeons must take the findings from the ACOSOG Z0011 trial, which evaluated axillary dissection versus no axillary dissection in women with invasive breast cancer and sentinel node metastasis and apply it to real-life patients. The fundamental lesson of this trial was that there is no benefit from removing normal healthy lymph nodes. Borgen says that the challenge is identifying the patients in which to do axillary dissection.
Although the uptake has been slow, Borgen says that so far, there has been a sharp decline of lymphedema rates in the United States. Ways in which to integrate these improvements into practice will be a topic of discussion at the 2019 Miami Breast Cancer Conference, Borgen concludes.