For many breast cancer patients, removal of lymph nodes in the armpit area is a common procedure, due to worries that the tumor has spread to these tissues. But the operation can also bring the difficult long-term side effect of lymphedema, a painful arm swelling.

Now, new Dutch research suggests that for early stage breast cancer patients, radiating the lymph nodes may bring about as good a chance of long-term survival as full removal-perhaps sparing women robust side effects

The new 10-year study finds that both lymph node removal or radiation treatments "provide excellent and comparable overall survival," said study co-author Dr. Mila Donker, a radiation oncologist at the Netherlands Cancer Institute.

Her team was scheduled to present the new findings Thursday at the annual San Antonio Breast Cancer Symposium. All things being equal, many women may opt for radiation only and spare themselves lymphedema, said one US oncologist.

The breast or armpit

"If, in fact, the rate of recurrence in the breast or armpit The same with radiation as opposed to the removal of lymph glands, this would make radiation very interesting as an alternative, "said Dr. Lauren Cassell, who was not involved in the new study. She directs breast surgery at Lenox Hill Hospital in New York City

The new research involved 1,425 women with early-stage breast cancer that had spread to their armpit lymph nodes and was found by biopsy. Each patient was randomly assigned to have either surgery (744 women) or radiation therapy (681 women).

Despues 10 years, recurrence of cancer in the armpit lymph nodes had occurred in 1.82% (11 out of 681 patients) of those who had received radiation therapy and 0.93% (7 out of 744 patients) of those who had undergone surgery.

Overall survival rates after 10 years were 81.4% for the radiation patients and 84.6% of those who had had lymph nodes removed, Donker's team found. Dr. Emiel Rutgers, a surgical oncologist at the Netherlands Cancer Institute in Amsterdam, was the lead researcher of the new study.

"Patients with early-stage invasive breast cancer who have no clinical evidence of local spread of disease to axillary (armpit) lymph nodes, meaning that palpation or ultrasound shows no sign of disease spread, undergo to sentinel lymph node biopsy," he explained a meeting news release.

However, "data from another recent clinical trial suggested that there may be some patients who do not need axillary treatment even if they have a positive sentinel lymph node biopsy," Rutgers added. The new study seems to reinforce that view, at least for some patients, I said.