For many women diagnosed with early-stage breast cancer, the biggest worry is whether the cancer has spread to the lymph nodes under the arm. If it has, a more extensive surgery is usually needed. For years, doctors have debated whether using an ultrasound machine before surgery helps find this spread better than just a physical exam. This study looked at that exact question to see if the extra scan actually changes patient care.
The team studied 4,806 patients across 34 sites in Europe. These women had early-stage breast cancer that had not spread to distant parts of the body. The researchers split the group into two: one group received an axillary ultrasound before surgery, while the other group relied only on a clinical exam. The main goal was to see if the ultrasound group found more cases of cancer in the lymph nodes compared to the exam-only group.
The results showed that the ultrasound did not make a difference. About 30% of patients in the ultrasound group had cancer in their lymph nodes, while 32% of patients in the exam-only group had it. This small difference was not statistically significant, meaning it could easily be due to chance. The amount of tumor tissue found in the nodes also did not differ between the two groups. Essentially, the scan did not reveal hidden cancer that the physical exam missed.
Safety was not a major concern in this report, as no adverse events were reported for the procedure itself. However, the study has important limitations. It focused on a very specific group of patients with early-stage disease. It did not report how long patients were followed after surgery, so we do not know if the lack of difference in node findings affected long-term survival or recurrence rates. Because the data comes from a single trial, we cannot assume these results apply to all breast cancer patients everywhere.
What does this mean for patients right now? It suggests that for this specific type of early breast cancer, an ultrasound scan before surgery might not be necessary to decide on the extent of the operation. Patients should discuss their individual situation with their doctor, as other factors like tumor size or location might still warrant a scan. This study helps clarify that for some patients, a simple physical exam is just as effective as a scan for staging the lymph nodes.