Health Partners: Novel Dye Saves Lymph Nodes in Women with Breast Cancer

October 5, 2023

The content below is provided by VCU Massey Cancer Center, a sponsor of H4TG’s A Calendar to Live By/Guide to Caring for Yourself.

Patients diagnosed with stage 0 breast cancer — called Ductal Carcinoma in Situ (DCIS) — have noninvasive tumors confined within the milk ducts. DCIS accounts for approximately one-fifth of all breast cancer cases.

Many patients getting a mastectomy for high-risk DCIS undergo a sentinel lymph node biopsy, in which an average of two lymph nodes are removed for analysis so that if invasive cancer is found, doctors can determine if it has spread to the lymph nodes.

The removal of lymph nodes can lead to a debilitating condition called lymphedema, the build-up of fluid in soft body tissue often causing reduced mobility, overwhelming pain, and swelling of the arm. This can significantly impact a patient’s quality of life, specifically for women who are overweight or lead sedentary lifestyles.

Only about 20% of women with high-risk DCIS are upgraded to a diagnosis of invasive breast cancer, meaning that nearly 4-in-5 women could be spared a surgical procedure to their axillary lymph nodes following the original removal of the cancer.

Recent research has indicated that using a magnetic tracer called Magtrace® could potentially eliminate the need for lymph node surgery altogether.

Surgeons typically identify lymph nodes by injecting a combination of dyes into the breast that trace the path the cancer would travel if it left the ducts. Magtrace® is a newer kind of dye made of iron oxide particles that stick around in the lymph nodes for weeks rather than hours. This allows doctors to inject it before performing a mastectomy and then use the pathology report from the breast tissue to decide whether to then remove any sentinel lymph nodes.

If the cancer is non-invasive, patients can safely keep their nodes intact, but if there is a concern that the cancer has spread, the Magtrace® dye is still there to guide a biopsy.

This new approach — known as delayed sentinel lymph node biopsy — could almost completely erase lymphedema in this patient population. Magtrace® is safe and FDA-approved for women undergoing full mastectomy.

The removal of someone’s lymph nodes follows them for the rest of their lives. I want my patients to both survive breast cancer and live their best lives. If I can help preserve their lymph nodes, that’s really exciting for me.

Content provided by VCU Massey Cancer Center. Kandace McGuire, M.D., chief of breast surgery and surgical leader of the Breast Health Program at VCU Massey Cancer Center



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