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|Mastectomy with Tissue Expander
Questions about Mastectomy with Tissue Expander.
|Asked||Publicly Submitted Question|
|4/2/2012||Not certain if this is the right forum, but thought I'd give it a go. I was diagnosed with invasive lobular 8/2011 and elected for a BMX due to age, 44: possibility of recurrence in 50s/60s, and fear of an endless life of biopsies. Premier surgeon in Rochester did BMX and SNB and final path results showed 1.2 ILC multifocal tumor with 4 mm of cancer to 1 of 2 sentinel nodes that were removed. Surgeon suggested chemo and tamoxifen. Did 4 rounds of cytoxin/taxotere and then was told by onc to see radiation oncologist due to multifocality and to consider ALND. Two rad oncs said yes to rads, but BC Board at Strong Hospital/U of R said they didn't think benefits outweighed risks for either and my surgeon still maintains that he is fine with chemo and tamoxifen. I would like to avoid radiation. I recognize recent studies that do not necessarily show increased survivorship with ALND in cases of only 1-3 nodes, but their idea of "surviving" is 5 years and I have two little children. My fear is that ILC is so hard to spot (I had mammos for 7 years before this was found via MRI) it could be growing on another lymph node and not be spotted until it's too late and then I am back to the drawing board.|
|Replied||JHU's Breast Center Reply|
|4/2/2012||Normally upon discovering disease in a sentinel node, and recognizing that mastectomy is being done, additional nodes would have been surgically removed at time of biopsy. The recent research regarding removing more nodes in the presence of a sentinel node being positive only applies to those having lumpectomy surgery and it is because it is a given that the patient will have radiation post op anyway therefore the radiation oncologist will be sure to include the axilla into the radiation field. Your situation is different and now it may be unknown even how many nodes you originally had positive. Each doctor has their own specialty-- surgeons do surgery, medical oncologists do chemo and hormonal therapy and biologic targeted therapies, radiation oncologists do radiation. Find out how many radiation oncologists were present for your tumor board case presentation and if all of them agreed with a plan of care for you. majority rules usually.|
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