Pondering Nodes & Such ...

Chevfan

Coming up quite soon ... Sept. or Oct. ... for my followup scans from my initial March mammo and u/s that ended with the ADH dx. So, I've been pondering some stuff (and I don't know why) but here goes:

I understand that nodes are removed and tested either negative or positive. Other than staging, why are they removed at all? Does it really help slow the spread if positive nodes are removed?

Just doing a proactive mulling over of all this. You know, back in April the BS thought I might come back DCIS. At that point, I was just off the cuff with "off they go if so". Now, I'm not so sure. Been reading about lymphedema and it feels like a sad trade off for some reason.

Guess I'm just wondering what good surgery actually does if you are dx with IDC and are going to get chemo and rads anyway?

P.S. I'm fine, just very anal. I gotta' think this stuff out far ahead when I get the chance.  

BarbaraA

Chevfan, chill. You can do it and whatever it is, based on your diagnosis, you can pull up the big girl panties and saddle up. I was dx with IDC, 1.8 cm, ER+, PR-, HER- Grade 2 Stage 1b. No family history. So I danced the dance and walked the walk and was recommended lumpectomy. Did that (5-10) and did not have clear margins. Honestly thought about a mastectomy at that time but by boobs are D's so I have lots of room. After the lump  I was told all 4 nodes were negative, found out with the path that one was positive with a micromet. Not happy (I am convinced there was contamination due to stuff I read in Path report and stuff surgeon said).  Did another re-excision (on 5-10) and then onc ordered OncoType Dx. I came in at 17.

As I am 58, I decided to forgo chemo.  Decided to do rads, as that pretty much kills recurrence in the same boob.

Moral of the story is, if the cancer is small enough to get out, get it out. Just my opinion.

However, having neoadjuvant chemo (chemo done before surgery) can be a very wonderful thing for many people. It has shrunk tumors to minuscule size.

RE: removing nodes, the standard is to remove sentinel nodes (1-6) and test. They are moving away from doing  axillary dissection now as the lymphedema risks are great and it is overkill according to many studies I have read.

Bottom line is, I was diagnosed 4/30 and I now have a BS in Breast Cancer Studies and am working on my masters as we speak.

mvspaulding

Chavfan, I hear you.  I was diag. with ADH in June and will be in your shoes come December.  Was wondering you were diag with ADH after a biopsy to confirm right?  What type of biopsy did you get?  I am wondering now after reading all of the posts on here about ADH if I should have my path slides re-read to get a second opinion.  Did you do that?

Missy 

Chevfan

Barbara, love your blog! You've got a way with words.

Missy, Yes I had a biopsy. I had a stereotactic biopsy and a needle aspiration biopsy on the same day. That led to the surgical biopsy couple of weeks later. I didn't get a 2nd opinion. At this point, I'm comfortable with the diagnosis. I was downgraded to ADH due to pathology, my surgeon originally thought it might be DCIS. I figure even if DCIS was missed, it won't make too much of a difference since I'm getting scans again soon. (What an attitude, LOL!)