New Approach To Breast Cancer

Sentinel Node Biopsy Identifies Cancerous Lymph Nodes

(CBS)  When Missy Krauss was diagnosed with breast cancer in August of 2000 she was given three options: removing the breast, removing the lymph nodes, or an experimental procedure known as a sentinel node biopsy.

"When you get a diagnosis like that your first inclination is to remove everything," said Krauss. "Take whatever you need to make me healthy and clean again."

But after learning that the new procedure was much less invasive with none of the potential pain and side effects of more drastic surgeries, Krauss signed up.

"It was so easy," she said.

Sentinel nodes, just as the name implies, are guards. They are the first line of defense once cancer starts spreading from the breast.

Over the years, cancer specialists like Dr. David Krag of the University of Vermont have theorized that removing many lymph nodes under the arm may be unnecessary when one or two sentinel nodes can tell the story.

"This is a very small procedure that can actually identify the cancer bearing lymph nodes better than the full surgical procedure," said Krag.

To find the sentinel nodes surgeons inject a low-level radioactive dye into the tumor site and follow it with something like a geiger-counter that leads them to their target.

Then, only those lymph nodes are removed and rushed to a pathology lab where it takes doctors about 20 minutes to determine if the cancer has spread.

In trials at the University of Vermont the procedure is proving 90 percent effective, but, "we have no long term information whatsoever about whether it provides the same cure rate as the conventional procedure," said Krag.

But doctors like Patrick Borgen aren't waiting for study results. A breast cancer surgeon at Memorial Sloan Kettering Cancer Center, Borgen said his experience has him convinced.

"We are absolutely satisfied that in experienced hands this is the treatment of choice," said Borgen.

For Krauss, it turned out to be a good choice. Two years later she's still cancer free with no scars to prove it.