Many of the advances in recent years have not been discoveries of new treatments, but rather discoveries that less invasive treatments are as effective as more invasive and/or more toxic standard of care. There is a growing recognition that more treatment is not necessarily better treatment. And, in fact, less is often better because of the reduction in long-term side effects, which are sometimes severe and occasionally fatal.
For example, over time, the standard of care included surgery to remove several lymph nodes in the armpits. The nodes are examined for the presence of cancer cells to assess the spread of disease. More recently, study results demonstrated no difference in survival between patients who underwent axillary lymph node dissection (ALND), or removal of over 10 lymph nodes, and those receiving a less invasive sentinel lymph node dissection (SLND), or removal of two to three lymph nodes. And patients receiving SLND only were less likely to suffer painful and debilitating lymphedema, a condition characterized by fluid retention and swelling in the arm and/or trunk caused by a compromised lymphatic system.