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Has anyone forgone sentinel node biopsies?
I am a newly diagnosed 66-year-old woman. I have IDC 8mm found by a twice-a-year check - one is a mammogram, and the other is an ultrasound (because I can't tolerate MRIs). Both of my sisters have had BC and are doing well now, 6+ years after diagnosis.
It was picked up by ultrasound. My lumpectomy surgery is scheduled for next week. New research shows that women 65 and older with IDC ER+ PR+ Her- and have an axilla ultrasound to look at nodes and all clear there, don't need to have sentinel nodes biopsied during surgery. Here is the original SOUND research and the follow-up done by Dana Faber, Mass General, and Brigham and Women's - with the same results.
I am not having my sentinel nodes biopsied as the markers for my cancer and my age fit.
I am having the onctoype test done on the tumor/tissue. This will decide the best course of treatment.
Has anyone else decided against sentinel biopsy because of this study?
Research:
1. Sentinel Lymph Node Biopsy vs No Axillary Surgery in Patients With Small Breast Cancer and Negative Results on Ultrasonography of Axillary Lymph Nodes
The SOUND Randomized Clinical Trial
2. Applying SOUND Trial Results in the Real World: New Study Identifies Appropriate Patients in a Multi-Disciplinary Clinical Practice Abstract: Real World Implications of the SOUND Trial Orlando, FL, April 11, 2024
"Given the similarity of our population to SOUND trial patients, our findings support thoughtful integration of these results into clinical practice,” states Dr. Giannakou. “Working closely with our multidisciplinary colleagues in medical and radiation oncology, we have started to implement this data into practice for select postmenopausal patients with HR+HER2- breast cancer who would have met eligibility criteria for the SOUND trial.”
1 Massachusetts General Hospital/Brigham and Women’s Hospital/Dana-Farber Cancer Institute, Boston, MA, 2 Brigham and Women’s Hospital, Boston, MA
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Me too!!! Thought I had done my research, but I also was unaware an ultrasound could detect that as I had an ultrasound. The lumpectomy was no big deal, but I'm still having a few issues with the node removal. Oh well, hopefully we will not have to face this again, but if we do, we will be better informed.
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3 Reactionsmaybe I wouldn't have qualified, as my tumour was not that small, was close to 2cm
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1 ReactionI think the trial criteria was for tumours of 1.5 cms or less.
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1 Reactionthanks for that info!
It seems it is up to 2cm.
“In the SOUND trial, the omission of axillary surgery was noninferior to surgical staging performed by SLNB when evaluating DDFS at 5 years in patients with BC up to 2 cm and a negative result on preoperative ultrasonography of axillary lymph nodes.” (JAMA)
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3 ReactionsI was diagnosed ILC STAGE 1a.
Surgeon and breast oncologist both said no need for lymph node bx.
Seems to be a trend from what I understand.
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1 Reactionreally wish that protocol had been available in my case, sigh
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2 ReactionsDid you have a DCIS in situ carcinoma? That's what I have & I'm scheduled for a mastectomy, which I think is overkill.
What did they tell you about oncotype. Just curious! Trying to gather more info.
I had lumpectomy and sentinal node biopsy two all clear. Small tumor 6mm, not taking anti estrogen drug. Having two year post mammogram coming up. Pray or send good thoughts for me. 54 yrs old with 5 kids. Nervous.
My oncotype was 19 percent. If I remember correctly!
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3 ReactionsNot DCIS but a small 7mm grade 2 tumour. The treatment plan was for minimally invasive surgery and radio therapy and aromatise inhibitor thereafter. Have you considered asking for a second opinion?