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Should my sentinal node be checked?
Dear Cleveland Clinic Dr.,
I need another opinion. I have a large DCIS 6.5cm x 4.5cm x 2cm high grade 3 comedo type breast cancer with .9mm of microinvasion. First lumpectomy did not produce clear margins on anterior and lateral sides. If I go for re-excision, 1. Should my sentinal node be tested? 2. What are the percentages with my grade and type of cancer that I'd have a postive sentinal node? 3. Is lymphedema a major concern for me with removal of the node? 4. All things considered, I am wondering if I should opt for mastectomy and avoid radiaiton or go the breast conservation route and radiation. Are chances of a cancer recurrance in that breast more or less or the same? By the way, I am 10% ER positive and PR negative. Thank you for taking the time to respond to all my questions.
I need another opinion. I have a large DCIS 6.5cm x 4.5cm x 2cm high grade 3 comedo type breast cancer with .9mm of microinvasion. First lumpectomy did not produce clear margins on anterior and lateral sides. If I go for re-excision, 1. Should my sentinal node be tested? 2. What are the percentages with my grade and type of cancer that I'd have a postive sentinal node? 3. Is lymphedema a major concern for me with removal of the node? 4. All things considered, I am wondering if I should opt for mastectomy and avoid radiaiton or go the breast conservation route and radiation. Are chances of a cancer recurrance in that breast more or less or the same? By the way, I am 10% ER positive and PR negative. Thank you for taking the time to respond to all my questions.
Hi Lucy,
don't know if this is helpful, but when I was dx with idc (2 cm, stage and grade 2) 5 yrs ago, they sampled 8 nodes at the lumpectomy. 2 were found malignant and I went back a month later for total axillary removal. Another node was found malignant (3/18) and I was advised to have chemo, as well as radiotherapy, which I had.
I luckily didn't get lymphoedema in my arm, but do have it in the affected breast, although this does not cause any pain or restriction of movement. I have had no recurrence and now considered NED (no evidence of disease).
On dx I was offered WLE (wide local excision = lumpectomy) with rads, or mastectomy and no rads. I chose WLE and rads, figuring if I did not get good margins, I could always go back for mastectomy. Right, but difficult decision to make at the time, and only you can make that decision. Chemo came as quite a shock as it was never discussed until after the total axillary removal surgery.
Still here, smelling the roses and enjoying life.
Take care,
Liz in England.
don't know if this is helpful, but when I was dx with idc (2 cm, stage and grade 2) 5 yrs ago, they sampled 8 nodes at the lumpectomy. 2 were found malignant and I went back a month later for total axillary removal. Another node was found malignant (3/18) and I was advised to have chemo, as well as radiotherapy, which I had.
I luckily didn't get lymphoedema in my arm, but do have it in the affected breast, although this does not cause any pain or restriction of movement. I have had no recurrence and now considered NED (no evidence of disease).
On dx I was offered WLE (wide local excision = lumpectomy) with rads, or mastectomy and no rads. I chose WLE and rads, figuring if I did not get good margins, I could always go back for mastectomy. Right, but difficult decision to make at the time, and only you can make that decision. Chemo came as quite a shock as it was never discussed until after the total axillary removal surgery.
Still here, smelling the roses and enjoying life.
Take care,
Liz in England.
MEDICAL PROFESSIONAL
Dear Lucy 55241c: Since you do have a small focus of invasive cancer, this would be cause enough to do a sentinel node biopsy. In many institutions, a sentinel node biopsy involves removing a small sample of nodes (about 5-8) rather than just the sentinel node. Positive lymph nodes are most common in women with large invasive tumors but it is not impossible to have positive nodes even with small tumors. With the limited number of nodes removed the chances for lymphedema is low. In general, mastectomy and lumpectomy with radiation have very similar survival rates. The local recurrence rate (recurrence in the affected breast) may be slightly higher in people who have lumpectomies.
Dear Liz,
Thank you for your response! Congratulations you are "5 years out". May I ask, are you doing vitamin supplements, exercise or other alternative therapies in conjunction with your traditional medical treatments? And, did you take Tamoxifen?
Glad you are smelling the roses and enjoying life! That's what its all about!
Lucy in USA
Thank you for your response! Congratulations you are "5 years out". May I ask, are you doing vitamin supplements, exercise or other alternative therapies in conjunction with your traditional medical treatments? And, did you take Tamoxifen?
Glad you are smelling the roses and enjoying life! That's what its all about!
Lucy in USA
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