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Page 322
| Mainstream Treatments |
| Surgery |
| Surgery remains the most frequent choice when breast cancer has been diagnosed. There are, however, a few important questions that should be answered before proceeding with this option. |
| 1. When should a mastectomy be performed as opposed to a lumpectomy? When there are multiple tumors or when the size of the tumor is too large and lumpectomy will cause significant deformity. |
| 2. What about axillary lymph node dissection. Is it necessary? Axillary lymph node dissection, the removal of lymph nodes for analysis, is often recommended by conventional oncologists. The theory is that axillary nodes can provide information about the probability of cancer recurrence and can therefore be used to help make decisions about the need for radiation and chemotherapy. |
| Recent studies have investigated the possibility of avoiding axillary dissection by relying on clinical information and primary tumor characteristics instead of nodal status for the staging of breast cancer. Better identification can be attained at the primary tumor than by axillary dissection, including tumor size, grading, and overexpression of certain genes (such as c-erbB-2 and p53). 46 In addition, use of a relatively new procedure called sentinel lymph node evaluation, a much less invasive procedure, is rising. In this procedure, also called lymphoscintography, dye and radioisotope tracers are used to identify one node that may signal the spread of cancer without disturbing the rest of the nodes. Use of this procedure helps to prevent complete axillary dissection in 80 to 90 percent of patients with early-stage breast cancer and avoids several complications, including chronic arm swelling (lymphedema). |
| My View |
| I am not in favor of axillary dissection because it can seriously compromise the immune system. In my opinion, the more surgical procedures (and accompanying disruptions to the immune system), the greater the risk of cancer |
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