New link in lymph node removal successful in Breast Cancer surgery
Written by Alyssa Clark
Researchers and scientists involved with breast cancer research have uncovered a connection, earning the name of “the conservative approach”, between removing lymph nodes and successful breast cancer surgery. It actually has called lesser harm for patient and has the same benefits as the more invasive, normal procedure.
Dr. Roshni Rao, associate professor of surgery at UT Southwestern, and other researchers from the Harold C. Simmons Cancer Center has referenced numerous case studies of patient results after women had undergone various forms of surgical treatment such as: removing one lymph node from the armpit region (to prevent the spread of the cancer) to removing an entire network of lymph nodes from the armpit region. The study was published earlier this week in the October 2nd edition of the Journal of the American Medical Association.
It has been standard practice within surgical methods to completely dissect axillary nodes (distributed at the edge of the chest muscles and into the armpits and lower neck), totaling all 20-30 nodes in an area, if the sentinel node biopsy deemed that the sample was positive. The sentinel node is usually the first node tested by doctors to check for cancer, since it is the place where cancer cells will spread from a primary tumor. The indication of a positive sentinel tests tells physicians and surgeons that the tumor is metastasized and can be used to determine the stage of cancer.
Reviews have reported that there is little proof to support doing a complete axillary dissection in comparison with the lone sentinel biopsy; this process will assist women with no suspicious axillary nodes undergoing breast-conserving therapy, which is defined as mastectomy followed by breast radiation.
"In the past, axillary nodal status was a critical factor considered in therapy decisions," said Dr. Rao, a breast cancer surgeon. "With the validation of sentinel lymph node biopsy, the same staging information can be obtained with less morbidity and risk to the patient. And now that decisions regarding chemotherapy are often guided by molecular tumor profiling in an era of personalized medicine, there are other avenues to explore beyond aggressive surgeries."
Dr. Rao and her associates have also compared the pros and cons of this sentinel node biopsy research and complete axillary node dissection with past, already published research. These important doctors have also looked at these procedures with nonsurgical interventions (which would mean adding more radiation) for women with breast cancer who do not have palpable lymph nodes or adequate ultrasound evidence.
Other authors include Dr. David Euhus,professor of surgery, a Simmons Cancer Center member and part of the Division of Surgical Oncology; Dr. Charles Balch, professor of surgery, oncology and dermatology and Deputy Director of the Johns Hopkins Institute for Clinical and Translational Research; and Helen Mayo, Faculty Associate in the UT Southwestern Library.
Visit UT Southwestern's Harold C. Simmons Cancer Center to learn more about cancer research, screening, and therapy at UT Southwestern, including highly individualized treatments at the region''s only National Cancer Institute-designated center.
About the Author
Alyssa Clark is the Editor of Healthcare Global
Introducing Dosis - the AI powered dosing platform
Cloud-based platform Dosis uses AI to help patients and clinicians tailor their medication plans. Shivrat Chhabra, CEO and co-founder, tells us how it works.
When and why was Dosis founded?
Divya, my co-founder and I founded Dosis in 2017 with the purpose of creating a personalised dosing platform. We see personalisation in so many aspects of our lives, but not in the amount of medication we receive. We came across some research at the University of Louisville that personalised the dosing of a class of drugs called ESAs that are used to treat chronic anaemia. We thought, if commercialised, this could greatly benefit the healthcare industry by introducing precision medicine to drug dosing.
The research also showed that by taking this personalised approach, less drugs were needed to achieve the same or better outcomes. That meant that patients were exposed to less medication, so there was a lower likelihood of side effects. It also meant that the cost of care was reduced.
What is the Strategic Anemia Advisor?
Dosis’s flagship product, Strategic Anemia Advisor (SAA), personalises the dosing of Erythropoiesis Stimulating Agents (ESAs). ESAs are a class of drugs used to treat chronic anaemia, a common complication of chronic kidney disease.
SAA takes into account a patient’s previous ESA doses and lab levels, determines the patient’s unique response to the drug and outputs an ESA dose recommendation to keep the patient within a specified therapeutic target range. Healthcare providers use SAA as a clinical decision support tool.
What else is Dosis working on?
In the near term, we are working on releasing a personalised dosing module for IV iron, another drug that’s used in tandem with ESAs to treat chronic anaemia. We’re also working on personalising the dosing for the three drugs used to treat Mineral Bone Disorder. We’re very excited to expand our platform to these new drugs.
What are Dosis' strategic goals for the next 2-3 years?
We strongly believe that personalised dosing will be the standard of care within the next decade, and we’re honored to be a part of making that future a reality. In the next few years, we see Dosis entering partnerships with other companies that operate within value-based care environments, where tools like ours that help reduce cost while maintaining or improving outcomes are extremely useful.
What do you think AI's greatest benefits to healthcare are?
If designed well, AI in healthcare allows for a practical and usable way to deploy solutions that would not be feasible otherwise. For example, it’s possible for someone to manually solve the mathematical equations necessary to personalise drug dosing, but it is just not practical. AI in healthcare offers an exciting path forward for implementing solutions that for so long have appeared impractical or impossible.