ANLD can't be performed by local doc after DIEP?

sophie456

Good evening,

I hope someone can shed some light on this.

During my Bilateral Mastectomy in NOLA (stacked DIEP last June)  I had the SNLB (one node removed) which was initially a false negative and several days later learned I had a micromet 0.3mm.  Due to that I am considering having a ALND especially if chemo wouldn't benefit me and if I can't have more radiation (I had radiation therapy two years ago to treat DCIS).  

I know this procedure has a high risk of lymphadema but I want to keep it open as an option.

My local surgeon in NY (At Sloan) said that ALND is an option but he would not want to perform it because he wouldn't know where to go in and where the blood vessels would be reconnected.  I asked if he could speak with the NOLA surgeon and he said it would be best to return to NOLA (the surgical oncolgist) if I want more lymph nodes removed.  

Is this fair treatment ? I am planning to to back to New Orleans in 2014 for Stage II but I can't really make a trip there this year.    Of course I can explore the option of rads under the armpit with my radiation oncologist and chemo if I need it.    I am awaiting my oncotype results and to clarify some discrepancies between the path report from NOLA and from Sloan.  

Thanks!