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Breast Cancer (Expert Forum)
2 questions - please
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
2 questions - please
by IKAP, Apr 28, 2004 12:00AM
Hello,
1) I was wondering what's more efficient for finding the breast cancer and lymph nodes involvement: MRI or US. I know none of them are 100% but which scan can more accurate distinguish if the breast lump is more likely benign or there is chance it can be malignant.
2) I had cancer in one breast and now planning to have prophylactic mastectomy on another breast. I am at higher risk of developing another breast cancer. Do you think the sentinel nodes should be removed during the prophylactic mastectomy? If not, could you please explain why. If the nodes are not taking and the cancer is found can the surgeon take sentinel nodes after the fact or all nodes will have to be removed?
Thank you.
1) I was wondering what's more efficient for finding the breast cancer and lymph nodes involvement: MRI or US. I know none of them are 100% but which scan can more accurate distinguish if the breast lump is more likely benign or there is chance it can be malignant.
2) I had cancer in one breast and now planning to have prophylactic mastectomy on another breast. I am at higher risk of developing another breast cancer. Do you think the sentinel nodes should be removed during the prophylactic mastectomy? If not, could you please explain why. If the nodes are not taking and the cancer is found can the surgeon take sentinel nodes after the fact or all nodes will have to be removed?
Thank you.
Doctor's Answer
by CCF-RN,MSN-rf, Apr 28, 2004 12:00AM
Dear IKAP: 1) Neither test distinguishes benign from malignant. They may indicate more or less suspicion but the only way to distinguish with certainty is biopsy. Each test may be ordered for different reasons.
2) If one is having a prophylactic mastectomy, there is no reason to remove any lymph nodes. By definition, prophylactic means it is being done for prevention - there is no cancer. If by some weird coincidence, cancer were discovered in the specimen, a discussion of whether or not lymph nodes should be removed and type of procedure would be discussed at that time. If there is a strong suspicion that there is cancer in the breast now, then this is not a prophylactic procedure and should be treated as such regarding addressing the lymph nodes.
2) If one is having a prophylactic mastectomy, there is no reason to remove any lymph nodes. By definition, prophylactic means it is being done for prevention - there is no cancer. If by some weird coincidence, cancer were discovered in the specimen, a discussion of whether or not lymph nodes should be removed and type of procedure would be discussed at that time. If there is a strong suspicion that there is cancer in the breast now, then this is not a prophylactic procedure and should be treated as such regarding addressing the lymph nodes.
