“That was very drastic,” Dr. Buonagura said. “Most of the time we don’t need that much surgery, because typically there’s not cancer in the lymph nodes.”
On top of that, removal of lymph nodes can come with complications, including a painful, life-altering condition called lymphedema, in which an arm or leg swells due to a build-up of fluid that is supposed to flow through the lymphatic system.
With delayed sentinel lymph node biopsy, a surgeon injects a special lymphatic tracing fluid – called Magtrace – designed to mark any at-risk lymph nodes.
Unlike other tracing fluids, Magtrace is magnetic, which makes it detectable for much longer than previous tracing products. Because of that, surgeons using Magtrace can wait until tests are conducted to indicate whether the cancer has spread to the lymph nodes. If it has, a limited number of targeted nodes are removed. If it hasn’t, none are removed.
“And even though it’s better to take out fewer lymph nodes, it’s even better not to take out any,” said Dr. Buonagura, who estimated roughly 20% of her patients are candidates for the Magtrace procedure.
Research from Uppsala University Hospital in Sweden and University Hospitals Cleveland has shown that the delayed sentinel lymph node biopsy procedure has reduced surgical interventions in 78.3% and 87% of cases respectively. It has also reduced costs to the healthcare system by 24.5% for women without invasive breast cancer.
That, says Dr. Buonagura, is no small thing.
“It’s always good to do less surgery if we can,” she said. “If we do less surgery, it’s better for the patient.”