Separate Axillary Dissection

I had the same situation except that I had surgery first, then had chemo afterward. My SNB was declared clear in the OR but a small amount of cancer, 20 isolated tumor cells (IST), less than micromets, was found in the more extensive exam in the lab. I had ALND surgery 5 weeks after BMX, and a much larger positive node was found further up the node chain. I was reluctant to have this additional surgery but my surgeon and oncologist were adamant due to the Her2+ aspect of my breast tumor. My surgeon is a progressive physician and former surgical dept head at an NCI center and I didn’t feel this was a reactionary decision, it was made with genuine concern for the aggressiveness of the situation. It was ultimately the right call in light of the size of the additional axillary cancer. I had imaging - mammo, ultrasound and MRI prior to surgery and this axillary cancer was never seen or palpated. The surgery was a relatively easy outpatient surgery, but I had some discomfort, tingling and aggravated nerves on the underside of my upper arm. I think this was more problematic for me because I was just recovering from the BMX rather than having had this surgery done simultaneously, and this was my dominant arm. The return of normal sensation to the inner arm was slow, but did happen.