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Topic: lymph node involvement?

Forum: IDC (Invasive Ductal Carcinoma) — Just diagnosed, in treatment, or finished treatment for IDC.

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Posted on: Oct 12, 2020 02:33PM

ealga wrote:

Hello,

I have my first in person appointment with my breast surgeon tomorrow to discuss my upcoming BMX. During our phone conversation, she indicated that she thinks the cancer is very small (around 4 mm) which was missed on mammo but found on MRI. Her approach would be to do the surgery, check the nodes, and if there is node involvement (she said she thinks it it unlikely) we would discuss next steps.

My question: should i ask for a lymph node biopsy before the surgery? Isn't it sometimes better to have chemo or rads beforehand vs after?

Any insight would be appreciated. xo

Dx 4/4/2013, DCIS, 5cm, Stage 0, Grade 3, 0/0 nodes, ER+/PR-, HER2- Surgery 5/15/2013 Lumpectomy: Right Surgery 7/10/2013 Lumpectomy: Right Radiation Therapy 8/28/2013 Breast Dx 9/23/2020, IDC, Right, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+/PR+, HER2-
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Oct 12, 2020 02:57PM Beesie wrote:

"My question: should i ask for a lymph node biopsy before the surgery? Isn't it sometimes better to have chemo or rads beforehand vs after?"

No, not necessary. What's being recommended is normal standard of care for a small ER+ / HER2- cancer.

Chemo prior to surgery is commonly considered for HER2+ and triple negative cancers, if the tumor is larger than 2cm, or if the patient is node positive. But for ER+ / HER2- cancers, chemo before surgery would only be considered if the tumor is very large (to shrink the tumor prior to surgery, possibly thereby allowing for a lumpectomy instead of a MX) or if there are many positive nodes (which is almost certainly not going to be the case for you, with such a small tumor and I assume, no suggestion from imaging that there might be nodal involvement).


“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Oct 12, 2020 03:01PM ealga wrote:

This is so helpful, Beesie, thank you!

Dx 4/4/2013, DCIS, 5cm, Stage 0, Grade 3, 0/0 nodes, ER+/PR-, HER2- Surgery 5/15/2013 Lumpectomy: Right Surgery 7/10/2013 Lumpectomy: Right Radiation Therapy 8/28/2013 Breast Dx 9/23/2020, IDC, Right, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+/PR+, HER2-
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Oct 12, 2020 03:07PM 2019whatayear wrote:

FWIW

I had a lymph node biopsy - it was a SN and it came back no cancer then when they my BMX the same sneaky son of a gun node came back with micromets so my doc did the ALND (8 additional nodes - no cancer)

So even if they do a lymph node biopsy it many not give a good picture

5/6/2019 IDC 2cm, micromet 1/9 nodes, BRCA2+, ER+, PR+, HER- BMX 6/2019, A/C & Taxol 2019, Radiation, BSO - preventative 2/2020, Letrozole 3/1/2020
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Oct 12, 2020 03:26PM ealga wrote:

oh wow. sneaky cancer. UGH. thanks.

Dx 4/4/2013, DCIS, 5cm, Stage 0, Grade 3, 0/0 nodes, ER+/PR-, HER2- Surgery 5/15/2013 Lumpectomy: Right Surgery 7/10/2013 Lumpectomy: Right Radiation Therapy 8/28/2013 Breast Dx 9/23/2020, IDC, Right, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER+/PR+, HER2-
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Oct 23, 2020 07:19PM Lilir wrote:

My sentinel node biopsy is occurring during my mastectomy. Also, if there is lymph node involvement, I am getting an axillary node dissection... 😢 All this so scary.

Your surgeon wants to bring u back to do acillary modes if necessary

Dx 9/21/2020, IDC, Right, <1cm, Grade 1, 0/2 nodes, ER+/PR+, HER2- (FISH) Dx 9/25/2020, LCIS, Left, 1cm
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Oct 23, 2020 09:24PM MinusTwo wrote:

I did not have ALND with my BMX. My SNBs were clear. I didn't have lymph involvement until 2 years down the road.

If you have a choice, discuss w/your oncologist what level of node involvement calls for ALND. Maybe if it's minor. maybe you don't need the whole excision - and maybe other treatments are available - like radiation &/or chemo.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Nov 2, 2020 09:13PM cleocat14 wrote:

Had a node biopsy on a suspicious looking node, and it came back negative. Surgery showed 2 tiny spots in 1 out of 5 sentinel lymph nodes removed. They just won't know about microscopic spots unless they take them out.

Dx 8/4/2020, IDC, Left, 1cm, Stage IA, Grade 2, 1/5 nodes, ER+/PR+, HER2- Surgery 9/29/2020 Lumpectomy: Left Radiation Therapy Whole-breast: Breast

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