Completion ALND or not

Hi!

I also had negative nodes during my mastectomy surgery and then the final path. showed a micrometastasis.

None of my drs. recommended an ALND and I figured that was because I was going to hit it hard and do chemo anyway, because my tumor was a grade 3.

I'm now done with chemo and I'm getting stronger everyday.  For me it was the right choice not to do an ALND.

If I were you, I'd do a lot more research. 

Check out the Lymphadema section of the message board. Ask your question there and see what responses you get because from what I understand, the more lymph nodes removed, the greater the risk for lymphadema.  And LE is a serious side effect of surgery as well as radiation.  

I hope that this helps.

(((hugs)))

Ann 

Same story here.  During lumpectomy, the SNB was negative.  Final path came back with micromets.  Surg. Onc says 11% chance more nodes are positive (doesn't that mean that 89% chance that more nodes are negative?).  Also I asked - Will the treatment plan change with finding (or not) more positive nodes?  Her answer - "No... It wont change treatment plan".  Also asked about change in survival rate - she stated " No change"  So my question was "why endure another surgery (even if it is minor)".  What are the chances of developing LE, wound infection, nerve damage, anesthesia complications and/or delay of Chemo tx? 

There is even a good article in the NY Times (dated June 3, 2008) regarding micromets.  Here's the link: www.nytimes.com/2008/06/03/health/03canc.html

The options given to you should be thoroughly researched thereby allowing YOU to make an informed and well-educated choice in your care.  This is your body and no one elses. 

I am fortunate in being a nurse and having access to lots of medical literature/books/library and helpful doctors to bounce my research off of.    I choose to forego a second surgery and just blast away any possible additional micromet nodes with Chemo and radiation - the odds are in my favor. 

If you doctor didn't give you a percentage of possible positive nodes, you can go to the Sloan-Kettering website at www.mskcc.org/mskcc/html/15938.cfm

open the calculator and put in you data.  It will calculate the percentage for you.

Hope this info helps,

Donna

Hi, all,

I really like what you had to say, Donna, about research allowing us to make OUR OWN care decisions. And since this particular decision also involves the risk of lymphedema, I wanted to add a web site that's good for lymphedema information. It's the National Lymphedema Network at www.lymphnet.org. Especially helpful are their Position papers on Risk Reduction, Exercise, and Air Travel.

It's really important to know that WE ARE ALL AT RISK for lymphedema, and that the risk extends for the rest of our lives. Both rads and ALND increase the risk, but even a prophylactic mastectomy puts us at risk because of severed lymph vessels and scar tissue.

The good news is that there are steps you can take to reduce your own risk. They're simple and you can fit them easily into your lifestyle. What you CAN'T fit easily into your life is a diagnosis of lymphedema , so please do some research and take the steps to protect yourself. It's well worth the effort!

Questions? Please feel free to join us "swell" gals on the Lymphedema After Surgery board. We'd all welcome your interest, because we're out to prevent this nasty side effect wherever we can.

Be well, all!

Binney