Surgical treatment for breast cancer has become less and less invasive as the decades go by. In most cases, mastectomy has been replaced by lumpectomy, and extensive lymph node removal by sentinel node biopsy.

    Now, in some types of breast cancer, surgeons can eliminate sentinel node biopsy altogether. Specifically, in older women with hormone-sensitive, HER2 negative cancer and no evidence of lymph node involvement, studies have shown that outcomes are the same with or without lymph node removal. Lymph node removal can cause side effects such as swelling and pain in the arm, so it is best to avoid it if possible.

    As with all scientific advances, implementation can be slow. According to the Medscape article linked above, many surgeons have changed their practice, but some have not.

    With any test or procedure, especially if it is invasive or might have side effects, it is important to ask whether the results will alter outcomes or management.