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|Lumpectomy with Sentinel Node Biopsy
Questions about Lumpectomy with Sentinel Node Biopsy.
|Asked||Publicly Submitted Question|
|6/14/2011||Hello from NM! 3 months ago, I was diagnosed with invasive Adenocarcinoma, Lobular. As the MRI indicated a small tumor, we went with a lumpectomy. But during the operation it became clear that the tumor was 6.1 cm. My brilliant surgeon was able to get clear margins (deep margin 4 mm, others >10mm), pathology also showed Nottingham grade 1, lymph node negative, 100% hormone receptor positive. So I thought all was well with surgery and am currently on chemo, planning radiation on that breast and ultimately tamoxifin or aromatase inhibitor therapy. But,I have since been told by two doctors that I should have had a mastectomy because due to the lobular nature of the cancer and because of the 6.1 cm size it will likely return and be upstoppable. What do you think of this? Should I have further surgery? Does this type typically return? BTW, I was on HRT,so I am wondering if the size was a "true size" or an inflated size because of the HRT. Does that make any difference to interpreting the size? My surgeon will do a mammogram and an MRI after chemo to look for calcifications (?) and something that might indicate we did not get it all, that is her feeling. I would appreciate your opinion on this situation. Thanks so very much,|
|Replied||JHU's Breast Center Reply|
|6/15/2011||Thank you for turning to the Johns Hopkins Breast center with your questions! Certainly bilateral mastectomy with reconstruction could have been an option. However, lumpectomy with treatment as you describe is an option (actually your reality) as well, and is totally appropriate. Yes, traditionally invasive lobular ca had 'the reputation' of recurring in opposite breast, not all studies support this. Invasive lobular ca does present as a diffuse, irregular and discontinuous growth pattern, (unlike invasive ductal ca) but curious why a 6.1 cm tumor did not appear on MRI. So, please seek a second opinion at an NCI Comprehensive Breast Center, where a team of breast cancer experts can review your case, examine, evaluate and advise you. Best wishes.|
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