BREAST CANCER: Expertise of Some Doing Biopsy Questioned
A new procedure to determine whether early-stage breast cancer has spread to the lymph nodes may save thousands of unnecessary lymph node removals, but "is gaining popularity so rapidly that leaders in the field are concerned that some surgeons may try it without being properly trained." If sentinel-node biopsies are done incorrectly and miss cancer, the "result can be fatal." Sentinel nodes are the "first ones to which a tumor will drain and have been found to be accurate in gauging whether cancer has spread to the entire lymph-node system of some 20 to 30 nodes," the New York Times reports. The procedure would allow an estimated 80,000 of the 100,000 women per year who undergo prophylactic removals of their entire lymph node systems to avoid the surgery, which carries the risk of lymphedema, "a debilitating and long-term swelling of the arm." Dr. Peter Pressman, a cancer surgeon and professor of surgical oncology at Albert Einstein College of Medicine in New York, "said patients should carefully question their own doctors to determine what training they have had in the procedure and how many they have done." And a team of researchers at Memorial Sloan-Kettering Cancer Center in New York recently published a paper in the Annals of Surgery showing that "two-types of material -- a blue dye and a radioactive isotope -- used in combination with the sentinel-node procedure markedly improved its accuracy" (Noble, 4/20).
In related news, the FDA approved yesterday a machine that "uses electricity to map possible breast lumps," potentially reducing the number of unnecessary biopsies. TransScan Medical Inc.'s T-Scan 2000, which shoots one-volt of electricity into the hand "where it travels through the body into the breast" and is detected by a hand-held probe, will attempt to complement breast X-rays -- "the gold standard in detecting breast cancer." The AP/Ft. Lauderdale Sun Sentinel reports that only 180,000 of the 800,000 women who undergo biopsies are diagnosed with breast cancer. TransScan says its device boosts diagnostic accuracy by 20% (Neergaard, 4/20).