Sentinel Node Results and Treatment

[NieceLynn]

Hi-I had a lumpectomy with sentinel node dissection.  Margins were found to be clear on the breast tissue and 6 nodes were removed, with the sentinel node resulting in a few minute, microscopic cells showing cancer upon staining. The surgeon said that the first node was the only one showing these few cancer cells-the remaining five were free and clear.  I believe that he said that it was minus .2 cm(I could be wrong on that measurement).  He said that no more surgery(further node dissection) would be warranted in this case.  Would most doctors agree with this?  If this is considered lymph node involvement, what is the usual route as far as further testing(cat scan, bone scans) and treatment? (I do not have the hormone receptiveness results yet-I am 35 and feeling healthy(I will be meeting with an oncologist-just trying to get a lot of opinions))  Thanks so much for your time and help!

[CCF-RN,MSN-rf]

Dear NieceLynn:  Clean tumor margins and micrometastasis in the sentinel node (with additional nodes testing negative) generally requires no further surgery.  If there is any cancer in a lymph node (even when it is only positive with immunohistochemistry staining) suggests lymph node involvement and this information will be considered in the determination of the proper follow up and treatment.  When you meet with your oncologist, and the remainder of the pathology information is available, a more precise plan can be made regarding your course of action.