The Paradigm Shift in the Management of Patients With Node-Positive Breast Cancer

Clinical Pearls

Henry M. Kuerer, MD, PhD, FACS, professor of surgery, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, discusses a paradigm shift in the management of patients with node-positive breast cancer.

• Chemotherapy and biologic agents can completely eradicate disease in 3-6 months in a significant amount of patients with node-positive breast cancer.
• Results from the ACOSOG Z1071 trial showed that the current sentinel node procedure has a fairly high false negative rate. There remains a need to be more accurate and do fewer surgeries.
• A trial was conducted in which physicians biopsied a patient’s lymph nodes, put a clip, and used an I-125 seed at the end to ensure that the node was removed and tested.