Lymph Node (Sentinal Vs Axillary)

[NM_southwest]

I have stage 1/ grade 3/ specimen removed @ 1.8 cm on 9.27.02.  I will be going in to day surgery 11.5.02. The surgeon recommeded an addition removal of 5mm more to get a clear margin. The original specimen was marginal. I have no problems with this, and also the sentinal lymph node proceedure. What I questioned was that he wanted to also extract additonal axillary nodes all at once. we posed a question and asked the surgeon what the gains are if we leave the axillary nodes in place and take the adjuvant therapy or removing the axillary nodes and adjuvant treatment. He reply very little difference.

we decided to keep the axillary node inplace and take the adjuvant therapy. ie (addition marigin 5mm lumpectomy ,sentinal node biopsy , raditions , chemo therapy , possibly hormone if estro is positive).

Question: is the doctor correct in his reply about the benefits between removing axillay node w/ adjuvant therapy or leaving  axillary node w/ adjuvant therapy.

[CCF-RN,MSN-JS]

Dear NM_southwest,  The reason for removing the axillary lymph nodes is for staging purposes.  This information will also contribute to what treatment will be recommended.  While in some cases it may make no treatment difference, the discovery of positive nodes may be an indication for more aggressive adjuvant therapy.  The use of sentinal lymph node dissection alone is still being researched.  The concern so far has been the incidence of skip metastasis (first node is negative but the second or third node may be positive).  It is being used alone in some very select cases.