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|Lumpectomy with Sentinel Node Biopsy
Questions about Lumpectomy with Sentinel Node Biopsy.
|Asked||Publicly Submitted Question|
|2/19/2006||My wife is considering a lumpectomy for tumor 1.5cm x 1.3cm x1.3cm according to MRI. The tumor is in the inner quadrant around 4 o'clock. We realize the procedure could take more tissue than one might hope. My question is, should the surgeon be able to get an idea of the margins by looking at the shape of the tumor on the MRI? Another aspect of this whole thing is that we will not know the lymph node status until after surgery. This is a hinderance in making decisions. The oncologist said she is going to undergoe chemo due to the size of the tumor. So my question is why not do chemo first? We have learned that this is common for larger tumors, and results can be amazing as far as tumor reduction goes. In addition the tumor can be accessed as to it's response to the drugs given. Other positives would be getting systematic treatment sooner, and the tumor may shrink making the lumpectomy less traumatic. Another positive would be that the results of BRCA genetic testing would be back which may help her to make the final decision of lumpectomy vs. mastectomy. Towards this end couldn't a sentinal bioposy be performed prior to start of chemo so she would have all the pieces of the puzzle, rather than waiting for it to be done at the time of breat surgery?|
|Replied||JHU's Breast Center Reply|
|2/19/2006||this is a small stage 1 tumor. lumpectomy should be very reasonable option, assuming not genetically positive. if you want to bring her to us for evaluation and surgery you are welcome to do so. we do the sentinel node biopsy at time of surgery and know immediately if it contains cancer or not. no waiting... there are many factors to consider before a decision is made about chemo too. hormone receptors. her2neu status. grade. her age. other factors too. whether the entire tumor truly is 1.5 cm or larger/smaller and is all of it invasive cells or a mixture of invasive and noninvasive. so consider bringing her our way. we also do a large volume of neoadjuvant chemo when we feel this is appropriate.(in such cases the lymph node is checked before chemo starts to know its status for staging and for planning chemo doses.)|
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