Breast cancer in lymph nodes indicates the cancer has spread. Lymph nodes are biopsied to determine if cancer has spread, and if so, treatment can include surgery, radiation, and systemic therapy. Stage II breast cancer is when cancer has spread to lymph nodes. Neoadjuvant therapy may be used before a mastectomy.
The presence of breast cancer in the lymph nodes is the first indication that the cancer has spread outside the breast. To determine whether breast cancer has spread, lymph nodes are often biopsied during a mastectomy or lymphectomy. Lymph nodes are immune organs where white blood cells accumulate, used to fight infections. In the body, lymph fluid circulates through the body and then returns to the lymph nodes where it is filtered for infections and foreign bodies. When there is breast cancer in the lymph nodes, the potential for metastasis throughout the body is greater because unfiltered cancer cells from the lymph can be circulated throughout the body.
Lymphatic fluid from breast tissue drains into three different lymph nodes: the axillary lymph nodes, located under the arms, and the lymph nodes near the collarbone and breastbone. The axillary lymph nodes are the first lymph nodes to receive lymphatic fluid from the breast and are therefore the lymph nodes that are biopsied. Occasionally, a special biopsy called a sentinel node biopsy is done in which the dye is injected into the breast and the first axillary node showing the dye is biopsied. The idea behind this procedure is that this sentinel node will be the most likely to contain cancer. If cancer is found, all lymph nodes are typically removed and tested for cancer.
To determine how far breast cancer has spread to the lymph nodes, the removed lymph nodes will be examined carefully. The survey results are usually presented to the patient as a report. For example, a ratio of three to four would mean that four lymph nodes were removed and cancer was found in three of them. The higher the ratio of cancer-containing lymph nodes, the more aggressive the breast cancer treatment.
Breast cancer is divided into four stages, with stage I being the least harmful and stage IV being the worst. The spread of breast cancer to the lymph nodes is designated as stage II cancer. Treatment for stage II breast cancer begins with, if not already done, a mastectomy and axillary lymphectomy. If the tumor was larger than 2 inches (5cm) or several lymph nodes were found to be contaminated, the surgery will often be followed by radiation of the area to destroy any cancer cells not removed by the surgery.
Adjuvant systemic therapy typically follows or is given concurrently with radiation to destroy any cancer cells that may have spread outside the lymph nodes. This type of therapy may involve chemotherapy or anticancer drugs; hormone therapy to reduce the production of progesterone and estrogen, promoters of breast cancer; or trastuzumab, a monoclonal antibody that reduces or stops the growth of cancer cells. When the cancer is in several lymph nodes, treatment can be more aggressive, and many of these therapies can be used together.
For women with stage II breast cancer who are hesitant to have a mastectomy, neoadjuvant therapy will be tried first. It is a short-term adjuvant systemic therapy, often quite aggressive, applied for a short time to see if the tumor can be destroyed before the breast tissue is harvested. If the tumor does not shrink after a predetermined trial period, a mastectomy is strongly recommended.
Protect your devices with Threat Protection by NordVPN
