Date: 9/1/2000

Community Hospital offers new breast surgery option to help spare women side effects

There is new hope for women facing breast surgery at The Community Hospital in Munster, Ind., thanks to a new surgical advancement that spares women potentially serious side effects of breast cancer surgery.

The procedure is called sentinel node biopsy, and Community Hospital is the first area medical center to offer it to women with breast cancer.

The method represents how research trials can offer significant improvements to conventional care, said Community Hospital Administrator Edward P. Robinson.

“Our surgeons are among a national network of researchers directing a new course of treatment that may dramatically change the way breast cancer is diagnosed,” Robinson said. “As a result, we are able to offer women with breast cancer the promise of a better quality of life as we share in the philosophy of modern cancer treatment - to help women live longer, and live well.”

Sentinel node biopsy involves removing only one to three under-arm lymph nodes, as opposed to 10 to 30, in order to effectively stage cancer in women who have been diagnosed with breast cancer.

“Research into the sentinel node biopsy procedure found that the removal of fewer lymph nodes may be associated with fewer complications and less pain for patients after surgery,” said Nabil Shabeeb, M.D., principal investigator for the sentinel node research trial at Community Hospital.

Lymph node biopsies become necessary when a woman has been diagnosed with breast cancer, and physicians must determine whether the cancer has spread. Research shows that when breast cancer spreads, it moves to the auxiliary lymph nodes generally under the arm.


In standard breast cancer surgery, between 10 to 30 of these auxiliary lymph nodes are removed
and studied to determine if cancer has spread outside the breast tissue. Physicians have determined that fluid draining from lymphatic vessels in breast tissue most likely reaches the sentinel node first. As cancer cells travel away from the primary site, they generally will affect this sentinel node before moving on to other lymph nodes “upstream.”

If cancer has not reached the sentinel node, chances are it has not spread from the primary site. With that in mind, physicians such as Shabeeb are now removing only the sentinel node and one to three surrounding nodes to detect whether cancer has spread.

Sparing women a full auxiliary node dissection also spares them potential side affects: pain, scarring, infection, numbness, impaired shoulder mobility, and lymphedema - a chronic condition caused by swelling and the buildup of access fluid.

When sentinel node biopsy research first began here a year ago, patients underwent both the biopsy and the full node dissection. Each surgeon who performs sentinel node biopsies at Community Hospital must perform a certain number of cases using both methods to demonstrate they are accurately identifying the sentinel node and diagnosing cancer.

“Until this procedure becomes the standard of care, women need to carefully research the experience of the surgeon and the experience of the institution performing sentinel node biopsy,” said Shabeeb, who is currently able to offer patients the sentinel node dissection without a full node dissection. “At Community Hospital, we are taking the necessary steps to demonstrate that this procedure can be used to accurately stage breast cancer and provide significant benefits to our patients.”

Ideal candidates for sentinel node biopsy are patients suspected of having early staged disease and tumors that are small in size. To learn more about this procedure, or other Community Hospital cancer clinical trials and minimally invasive breast surgery options, contact the Women’s Diagnostic Center at Community Hospital, 219-836-6769.