Studies Examine Microscopic Lymph Node Tumors, Lymphedema In Women With Breast Cancer

Main Category: Breast Cancer
Also Included In: Lymphology/Lymphedema
Article Date: 17 Aug 2009 - 0:00 PDT

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The following summarizes news coverage of recent breast cancer-related studies.

~ Treatment of microscopic tumors: Women with breast cancer who develop microscopic tumors or isolated cancer cells in the lymph nodes have a much higher risk of recurrence and might benefit from more aggressive therapy than is typically prescribed, according to a study published on Thursday in the New England Journal of Medicine, the AP/ABC News reports (Marchione, AP/ABCNews, 8/12). Under current treatment standards, tumor cells smaller than one-sixteenth of an inch in the lymph nodes are usually ignored, and the node is considered cancer-free. Patients in such cases might receive a lumpectomy and radiation, but they usually do not undergo more aggressive treatment. The study, led by oncologists at Maastricht University Medical Center in the Netherlands, followed 856 patients with microscopic tumor cells in the lymph nodes who did not receive chemotherapy or hormonal treatment, as well as 995 similar patients who received such treatment. After five years, 86% of the treatment group remained disease-free, compared with 77% of the group that did not receive treatment. Oncology experts say that the findings could change the standard of care for 2% to 6% of the 184,000 women who develop breast cancer annually in the U.S. (Levitz, Wall Street Journal, 8/12).

~ Weightlifting for lymphedema: Strength training may help breast cancer survivors avoid flare ups of lymphedema -- an incurable, painful swelling of the arm that can result from some cancer surgeries -- according to a study published on Thursday in the NEJM, USA Today reports. For years, breast cancer survivors have been told to lift as little as possible because doing so could lead to the condition. The study, which was partially funded by NIH, focused on 141 lymphedema patients with an average age in the mid-50s. Half were assigned to a structured weightlifting class. According to study co-author Kathryn Schmitz of the University of Pennsylvania School of Medicine, women in the weightlifting group could bench-press an average of 53 pounds by the end of the course, an improvement of 29%. After one year, 14% of the weightlifters experienced a lymphedema flare-up, compared with 29% of the other group. Jennifer Ligibel of the Dana-Farber Cancer Institute said that avoiding lifting can weaken the bones and muscle, making them more susceptible to injury and flare-ups (Szabo, USA Today, 8/13). In an editorial accompanying the study, Wendy Demark-Wahnefried of the University of Texas M.D. Anderson Cancer Center wrote that the weightlifting program also could save money, as the women in the group made 77 visits to the doctor or physical therapist, compared with 195 for the other group (Marchione, AP/San Francisco Chronicle, 8/12).

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