need snb?

carlite

Surgeon did not do a sentinel node biopsy when they did my lumpectomye a week ago. I have high grade DCIS with comedonecrosis and wondering if I should ask for on the biopsy

redsox

For DCIS they do not usually do sentinel node biopsy (SNB) with a lumpectomy.  If the pathology comes back with invasive cancer in addition to the DCIS they may want to do one. 

For someone who has a mastectomy for DCIS they usually do SNB because they can't go back for the SNB if the pathology shows invasive but the breast is no longer there. Then they would have to do a full axillary dissection to test the nodes. 

Beesie

I'll second what redsox said.  With a lumpectomy for DCIS, an SNB is not usually done.

It's a question of risk vs. benefit.  Because DCIS is contained in the milk ducts and cannot travel to the nodes, an SNB is not necessary when the diagnosis is pure DCIS.  Although only one or a small number of nodes are removed during an SNB, just the removal of a single node presents a life-long risk of lymphedema in the range of 3% - 7% (some believe the risk is higher because lymphedema is not always properly diagnosed).  For someone with pure DCIS, the risk of lymphedema from the SNB significantly outweighs the likelihood that there might be an occult invasion (i.e. a tiny area of invasive cancer that was never found in the pathology of the breast tissue) AND that this tiny never-detected invasive cancer has already spread to the nodes. 

carlite

Thanks so much good information!

patti3796

If you read some posts you may find some like me that had DCIS and had a snb. In my case I had invasive cancer in the other breast eight years ago. Although the biopsy had indicated DCIS the surgeon and radiologist were worried that there may be some invasive cancer in there. So did the snb. It turned out to be DCIS. So when you hear of some of us having the snb.....it may be because of other factors.