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Rads vs ALND?
by Suzie2, Nov 27, 2007 06:47AM
I was dx'd with Stage I, Grade I IDC. Sentinel node biopsy at time of surgery (lumpectomy) was negative but after H&E staining and IHC by pathology they found foci micromets of .86mm & .74mm. Onc gave me the choice of having axillary lymph node dissection or radiation to armpit. He said in some rare cases the procedure or biopsy could have caused "transient" cells to migrate to the sentinel node. He recommended I get the ALND to be sure of no other nodes being positive. My question is, I already know I will have radiation to my breast and 4 rounds of AC plus tamoxifen. I am 49 yrs old, premenopausal and the tumor was er-/pr+ @50%. I have just recovered from the lumpectomy with no complications and after some research, I am not sure I really want to go thru more surgery if I am getting the "triple treatment" and this was stage I, grade I. Do you know of any studies or info that has addressed radiation to the armpit vs alnd? I am thinking of going for a second opinion before my surgery.
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Your case reports points towards a Stage I Breast cancer with sentinel node being negative but was found to be positive for micro-metastasis on Immuno-histochemistry. Now the dilemma is whether to undergo axillary lymph node dissection for these positive nodes. Being stage I and having a better prognosis it is advisable that you undergo ALND and adjuvant Radiotherapy in combination with Tamoxifen.