Breast surgeons can now avoid sentinel lymph node biopsies during mastectomies for early-stage breast cancer to reduce patients’ risk of lymphedema
Nuvance Health now offers Magtrace® lymphatic tracer for patients undergoing a mastectomy to treat ductal carcinoma in situ (DCIS). Breast surgeons at Danbury Hospital, Norwalk Hospital, Northern Dutchess Hospital and Vassar Brothers Medical Center can now avoid proactively performing a sentinel lymph node biopsy and reduce a patient’s risk of developing lymphedema.
DCIS is an early form of breast cancer that develops in the milk ducts. Depending on the extent of DCIS and genetic testing, a breast surgeon will recommend a lumpectomy to remove the cancer and surrounding breast tissue, or a mastectomy to remove the entire breast.
After a lumpectomy to treat DCIS, a pathologist analyzes the removed breast tissue to determine if there is invasive cancer or not. If there is invasive cancer, the breast surgeon will perform a second surgery to remove the lymph nodes where the cancer has spread.
Unlike a lumpectomy, if pathology shows invasive breast cancer after a mastectomy, it is not possible for the breast surgeon to locate and remove lymph nodes during a second surgery.
Therefore, at the time of the mastectomy, the breast surgeon will proactively perform a sentinel lymph node biopsy just in case pathology shows invasive breast cancer. A sentinel lymph node is the first lymph node where cancer cells are most likely to spread from a primary tumor.
In up to 80% of DCIS mastectomy cases, a sentinel lymph node biopsy is not necessary because pathology confirms the breast cancer is noninvasive.
Lymphedema is a common side effect from lymph node removal or damage due to cancer treatment or surgery. Lymphedema can cause pain and swelling in the arms or breasts from abnormal accumulation of protein-rich fluid. There is no cure for lymphedema, but people can manage symptoms through lymph drainage, compression garments or exercise.
With Magtrace, the breast surgeon injects a liquid tracer into the breast during the mastectomy. Magtrace stays in the lymph nodes for 30 days. If pathology shows invasive cancer, the breast surgeon can now locate and remove lymph nodes because the safe, non-toxic dye travels the same way cancer would if it were to spread through the lymphatic system.
“We can now greatly reduce a patient’s risk of developing lymphedema after a mastectomy to treat DCIS because we do not need to remove lymph nodes at the time of the original surgery,” said Dr. Susan K. Boolbol, system chief of breast surgical oncology and breast program at Nuvance Health.
Jennifer*, 57, had DCIS and Dr. Boolbol performed a mastectomy using Magtrace.
“I was very happy to hear that the lymphatic tracer was an option. My friend had metastatic breast cancer and I observed her struggle with lymphedema; it seemed very painful for her,” said Jennifer, a Nuvance Health breast cancer patient. Read Jennifer’s full story.
“Pathology from Jennifer’s mastectomy confirmed the cancer was stage 0, which meant it was noninvasive and had not spread. We were able to preserve all her lymph nodes using Magtrace and reduce the risk of her developing lymphedema,” said Dr. Boolbol.
“Magtrace is one component to Nuvance Health’s comprehensive breast cancer program that includes screening, diagnostic testing, surgery, medical oncology, radiation oncology, nurse navigation, nutrition counseling, therapy and social work support, and more,” said Dr. Boolbol. “We are not only passionate about bringing the latest breast cancer care to our patients, but treatments and services that promote quality of life and overall wellness.”
*The patient’s name has been changed to protect her privacy.