Breast cancer now treated without removing lymph nodes
A great oncologist, Virgilio Sacchini, brings to Italy the revolutionary breakthrough in breast cancer treatment already used in the United States. Now many women with breast cancer will no longer have to have their lymph nodes removed. The story previewed in Donna Moderna
Well-known oncologist Virgilio Sacchini, who has returned from Memorial Sloan Kettering Cancer Center in New York to the European Institute of Oncology in Milan as director of the senology program, exclusively tells us about the breast cancer news he is "importing" to Italy.
Are sentinel nodes always removed?
If the sentinel lymph node, i.e., the first one located on the lymphatic network from the breast to the armpit, is found to be attacked by the disease, in the U.S. it is not always removed along with the other lymph nodes. What happens in Italy? In our country, axillary emptying surgery, as it is called, is still common practice. "Twenty years ago, the discovery of the sentinel lymph node was a big breakthrough," says Dr. Sacchini. "But new studies have changed the international standard of treatment. So much so that the new approach is in the National Cancer Institute guidelines. And, as of mid-May 2016, the new sentinel lymph node treatment is also in the treatment plans of the Ieo, first in Italy."
In practice, if there are fewer than three positive lymph nodes, they are not removed. Because therapies after surgery clean out any remaining cancer cells. "This prevents the woman from swelling of the arm, so-called lymphedema, and problems such as decreased sensation and limitations of movement in the operated arm," says the expert.
What is the new liquid biopsy test?
A clinical trial to assess tumor Dna in the blood is starting soon. This test is also already being performed in the United States. "We know that the tumor leaves traces of its presence in the blood," Dr. Sacchini continues. "They are Dna crumbs: by assaying them, we follow the tumor's reaction as we go through treatment. And, thanks to increasingly targeted drugs, we can block any mutations in it, with the goal of destroying the cancer."
What does integrated mean in medicine?
Spottily, integrated oncology outpatient clinics are also springing up in Italy, where doctors with expertise in various complementary medicines such as acupuncture, phytotherapy and homeopathy work alongside oncologists to alleviate the negative effects of cancer treatments and improve the quality of life of patients. "Every hospital should have a dedicated space," Dr. Sacchini concludes. "At the Ieo it is lacking, but the project has already taken off. The goal is to import the American model, with a team of physicians trained in the subject and medical records shared with oncologists."
