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By Reuters / Lisa Rapaport

For women with early-stage breast cancer, many surgeons would advise extensive removal of the lymph nodes under the armpits even though recent evidence shows this doesn’t improve survival or the odds of cancer recurring, a U.S. study found.

Nearly half of breast cancer surgeons surveyed said they would recommend the procedure, known as axillary node dissection, despite modern guidelines that recommend against it.

Women have 20 to 40 lymph nodes under the armpits. When cancer surgeons remove an early-stage breast tumor, they also remove a few “sentinel lymph nodes,” so-called because they’re the first lymph nodes to which cancer cells are most likely to spread from the original tumor.

In the past, when sentinel nodes contained cancer cells, surgeons would routinely cut out most or all of the remaining nodes to prevent the cancer from spreading or recurring. But based on the most current evidence, the American Society of Clinical Oncology changed its guidelines in 2014 to say that women with one or two positive sentinel nodes who plan to have lumpectomy plus radiation don’t need axillary node surgery.

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Dr. Ben Anderson, Professor of Global Health and Surgery, is quoted in this story and wrote an editorial to accompany the study. 

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