A LESS-drastic option than the traditional surgery undertaken in the diagnosis and treatment of early-stage breast cancer is now available, a guest speaker said at the recently-held Malaysian Healthcare Seminar at the International Convention Centre.Dr Harjit Kaur, a breast and endocrine consultant and surgeon from the Prince Court Medical Centre (PCMC) in Kuala Lumpur, explained to The Brunei Times that PCMC was the first and is still the only hospital in Malaysia to perform sentinel lymph node (SLN) biopsy.
A lymph node is an organ of the immune system which traps cancer cells, bacteria or other harmful antigens. Groups of lymph nodes are found in the neck, armpits, chest, abdomen and groin.
The SLN, Dr Kaur explained, is what doctors call the first lymph node to trap cancer cells that are spreading from the primary tumour.
“Breast cancer surgery is not just the breast surgery, the most important part is the axillary (armpit) lymph node surgery,” explained Dr Kaur.
Axillary surgery is important in determining whether the cancer has spread to the lymph nodes and for determining whether the cancer is stage one, two, three or four, she added.
“Traditionally axillary surgery requires removing about two-thirds of lymph nodes in the armpit. That’s quite a radical dissection in the armpit,” she said.
Dr Kaur said that doing this exposes patients to many complications, including stiff shoulders, pain, numbness, loss of efficiency of the arm and, most dreaded, lymphedema, the swelling caused by excess fluid build-up, which is experienced by 20 per cent of women who undergo the surgery.
“When you are able to identify the first lymph node that ‘drains the breast’ (starts trapping cancer cells from the breast), you are able to determine if the cancer has spread to the lymph nodes. So the principle is: if the lymph node is cancer-free, one need not have the full axillary surgery,” she said.
“This spares a large number of women from undergoing unnecessary (surgery) and ending up with problems,” she added.
Dr Kaur said that most women who have undergone traditional axillary surgery have found the lymph nodes removed to be free of cancer.
By delivering her presentation in Brunei, Dr Kaur said she hoped to give the public more options for their medical care.
Asked about cost, Dr Kaur said the simplest of surgeries to the most complicated could range from around RM12,000 (about $5,000) to RM20,000 (about $8,300).
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