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Breast Cancer (Expert Forum)
SNB after stereotactic biopsy
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.
Doctor's Answer
by CCF-RN,MSN-JS, Jun 10, 2003 12:00AM
Dear csibi, Having had a stereotactic biopsy should not interfere with the ability to perform an accurate sentinel lymph node biopsy. The sentinel lymph node (SLN) is the first lymph node to drain the primary tumor. The theory is, if the SLN does not contain cancer then the lymph nodes “down stream” of the SLN would also not contain cancer. Sentinel lymph node biopsy has not yet proven to be as accurate as lymph node dissection due to a phenomenon called "skip metastasis." skip metastasis is when the first or second lymph node may be negative and a lymph node that is further up the chain may be positive. It is for this reason that lymph node dissections, rather than exclusive sentinel lymph node biopsies are recommended in many institutions. The findings from the biopsy, location and size of the tumor, as well as the experience of the surgeon with SLN biopsy help determine if this would be an appropriate way to go. The purpose of removing lymph nodes is to plan treatment and provide information to help with staging and prognosis.
As to the question of tumor spread after biopsy, the biopsy does not cause the tumor to spread.
As to the question of tumor spread after biopsy, the biopsy does not cause the tumor to spread.
Member Comments (2)
by surgeon, Jun 07, 2003 12:00AM
there is around a 2 - 10% false negative rate; meaning that the sentinal node is ok but there is tumor in other nodes not checked. The rate depends to some extent on experience. There really isn't a false positive rate: if the node has tumor in it, it has tumor in it. There's no way to be wrong about that. As to biopsy spreading tumor: it's a common concern. My answer is this. For a small tumor, the cure rate of breast cancer is around 90%. Every person with a cancer has had it biopsied in some way, whether with needle, scalpel, etc. There's no way to diagnose it without manipulating it first in some way. Since all women cured have had such manipulation, it's clear the manipulation doesn't prevent cure.
