lymph node dissection/nipple sparing surgery.

kae_md99

Hi all,

just got diagnosed and will see my oncologic surgeon next week,possibly BMX. question about lymph node dissection, is there a certain rule or guideline as to how many sentinel nodes are positive before they do ALND? does ALND always mean lymphedema? also, my mri showed my nipples are not involved,but will the surgeon still take some nipple tissue for biopsy just to make sure? thanks in advance!

kae

jojo9999

Sorry you are here. Finding positive nodes from SLN biopsy doesn't necessarily mean they will do a ALND - based on a study a few years back showing that radiation to the axilia instead of ALND had similar efficiacy with less risk of lympodema. But I am sure it all depends on how many are positive. I had 1 out of 4, and had radiation because of the positive node. all good so far. good luck.

kae_md99

thanks jojo! at the surgery, they do get the sentinel nodes and do a frozen section right? so they know right away how many nodes are affected and then maybe the surgeon will decide if he will do ALND?

kae

jojo9999

Make sure to ask the surgeon about the plan if positive nodes are found - does he/she think that radiaiton is a viable alternative to ALND. I should warn you that the examination of the nodes done at the time of the SLNB in the operating room isn't as thorough as what is done afterwards in the pathology lab. There have been cases of negative SLN but upon further inspection in the path lab they find it to be positive - probably small, micromets, but it does happen. Overall, positive SLN doesn't necessarily mean ALND and it no longer means that chemo is an automatic either, although there are still some docs out there who go by the older standards. Ask questions - and make sure to write down the answers, or record the conversation.

kae_md99

thanks Jojo! i will ask my BS those questions and i will bring a notebook with me.