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|Lumpectomy with Sentinel Node Biopsy
Questions about Lumpectomy with Sentinel Node Biopsy.
|Asked||Publicly Submitted Question|
|07/24/2003||To the Breast Cancer Experts: A week ago, my sister, 37 years old, 30 weeks pregnant, discovered a medialy lump, not connected to the areola. In the ultrasound, they found a 1.6 cm diameter lump. They ran a biopsy, and the result was invasive duct carcenoma grade 1 or 2. Ultrasound tests of the liver and lymph nodes came out clean, ER+, PR+. She got several options: 1) to do a lumpectomy with sentinel node biopsy with general anesthesia and/or local anesthesia, wait five more weeks and induce labor or do a C-section, and then chemotherapy, or 2) to wait five more weeks, and then to do everything mentioned above. Are there particular risks in choosing one of the two options over the other, for her or the baby? Does the fact that she is pregnant affect the prognosis? Do the facts that the lump tested positive for ER and PR and that she is pregnant mean that there has to be an immediate lumpectomy? Can sentinel node biopsy be done effectively during pregnancy? What would you suggest to do under these circumstances? Thank you very much.|
|Replied||JHU's Breast Center Reply|
|07/27/2003||What a shock for your family-- excited about a new baby coming into this world to have everyone's world rocked with a diagnosis of breast cancer for the new mom to be. Most doctors would also give the two options, but potentially lean toward surgery now, since 10 weeks for full gestation is far away. A key factor is the method that the surgeon would plan to do the sentinel node biopsy--- check to ensure that the method proposed doesn't cross the placental barrier. Most surgeons would probably look at doing the surgery now, and then waiting for baby to be born, coming earlier than the stork intended, to persue the rest. The sentinel node can also be done post lumpectomy too-- with the breast still there the breast can be injected and the sentinel node still identified if done by someone who is highly skilled in doing this method. There isn't a lot known about pregnancy and hormone receptors being positive. some would raise it as a concern though. She is young and probably otherwise healthy so the odds are in her favor to overcome this. no breast feeding should be considered or planned for the obvious reason that it interferes with surgery and also is effected by chemo and radiation. There is an organization called "pregnant with cancer" based in Buffalo NY-- national group-- that she might want to check out. For your mother, consider contacting Mothers Supporting Daughters with Breast Cancer to provide support to her. she would be matched with a mother volunteer who also in the past has had a daughter diagnosed during her own pregnancy too. take care.|
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