Thousands of breast cancer patients could be spared lifelong arm swelling after a major study found that invasive lymph node removal is often unnecessary. The research, presented at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago, followed 2,540 women from Sweden, Denmark, Germany, Greece, and Italy whose cancer had spread to one or two nearby lymph nodes. Among those who avoided axillary lymph node dissection (ALND) and received only radiotherapy, the five-year survival rate was slightly higher at 94%, and arm function was significantly better, according to the study.

The 94% survival finding that challenges standard practice

The study's lead author, Dr. Jana de Boniface,told the ASCO meeting that the key result is straightforward: more axillary surgery does not improve survival in these patients. The five-year survival rate in the no-surgery group was 94%, compared to a similar rate in the surgery-plus-radiation group. This finding, as the source reports, echoes earlier trials that questioned the necessity of ALND, but this is the first large-scale study to include women undergoing mastectomy or those with tumours larger than two millimetres.

Why half of women who get ALND develop lymphoedema

Lymphoedema, a long-term condition causing tissue swelling, affects nearly one-fifth of breast cancer patients after gland surgery. According to the source, around half of women who undergo ALND develop the condition, which can severely limit mobility, cause discomfort, and damge self-esteem. In the study, patients rated their arm symptoms on a scale of 0 to 100, and after five years, those who avoided surgery reported markedly lower scores. the findings offer a path to drastically reduce what Dr. jane Lowe Meisel, a breast cancer expert quoted in the source, called a “devastating quality-of-life issue.”

What remains unclear for mastectomy and larger tumour patients

Before this trial, doctors were unsure whether omitting ALND was safe for women having a mastectomy or those with larger primary tumours. As the source notes, Dr. de Boniface stated that previous studies left this question open. The new results suggest it is safe, but the study only followed patients for five years. Longer-term data on recurrence and survival will be needed to confirm whether the benefit holds, particularly for women with more aggressive tumour biology.

A shift from therapeutic to diagnostic: Dr . de Boniface's call

The study's lead author concluded that axillary surgery should be seen as a diagnostic instrument, not a therapeutic one. The source reports her words directly: “more axillary surgery in itself does not improve survival in these patients.” This conceptual shift, if adopted widely,could reshape surgical guidelines and spare many women from unnecessary procedures. bunia Gorelick, associate director of research at Breast Cancer Now, told the source that the research is a valuable contribution, but early to implement globally .