Lymph node surgery before neoadjuvant chemo?

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KV99
KV99 Member Posts: 18
edited September 2019 in Surgery - Before, During, and After

Hi, I am a recently diagnosed newbie, and have been deciding which drs and practices to go to this week. Both agree that I must have chemo first before surgery. One breast surgeon suggested she could go in and look at a lymph nodes now, and that was more for peace of mind and knowledge about what's going on with the cancer, or she could just wait until surgery. The other breast surgeon was emphatic that the lymph nodes should only be done after the chemo and as part of the breast surgery. Anyone faced this differing opinion or have any information on what to do?

Thank you for any information!

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited September 2019

    If I were in your shoes, doing neoadjuvent chemo, I would definitely want to have more information about my nodal status prior to starting a process that may mask the true situation. I think the doc who suggested doing a pre-chemo SNB is forward thinking. Have you had any imaging or exam that suggests nodal involvement? Are you having a port installed? I have suggested to friends that are doing chemo first to have their SNB done at the time of port install (if needed), bonus if your BS can do both procedures.

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  • hapa
    hapa Member Posts: 920
    edited September 2019

    If you have your SNB before chemo and it comes back positive, does that mean an automatic ALND? Because you can't do another SNB after chemo if they've already been removed. On the other hand, even if you do have cancer in your sentinel nodes now, they may be clear after chemo and you'll be able to avoid ALND. I would try to avoid the ALND if at all possible.

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  • Newfromny
    Newfromny Member Posts: 139
    edited September 2019

    I had a positive node before chemo and probably 2 more positive according to an mri, but after chemo mri showed no cancer. Surgery included SNB and 2 additional but avoided ALND. Had complete response nodes all negative so was able to avoid ALND

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