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This question was answered on Mon 12, Dec 2011 03:51pm by bobby s, md

Breast Cancer Surgery Tomorrow


    
Asked by spartacus407 0 on Mon 12, Dec 2011 02:00pm
Priced at $9.00

I am a 55 year old recently diagnosed with recurrent breast cancer in the small amount of tissue that was left in the breast that was removed. I had a mastectomy 9 years ago. I am having surgery tomorrow to remove the tumor but am concerned as to why there was so much breast tissue left in my breast. The tumor is 1cm and located in the breast tissue but the surgeon says he will need to remove some muscle as well. Why would he need to remove muscle? Most importantly, I asked him if he would be testing my lymph nodes under my arm (he removed 9 last time and they tested negative) and my mammary lymph nodes as well. He said he would not be testing either because it is dangerous to re-test them again. Does this make sense? How will they stage me if they don't know if it's in my lymph nodes? He says it doesn't matter because I will receive radiation and chemo regardless. This concerns me.
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Answer by bobby s, md  on Mon 12, Dec 2011 03:51pm:

Hello,
Some amount of breast tissue is always left behind at mastectomy. This is normal.
At the present time, if your recurrent tumor is adjacent to the chest wall muscle, then it is reasonable for the surgeon to remove a layer of normal surrounding muscle tissue. This is in keeping with principles of surgical oncology. About lymph nodes, it may be challenging to identify and remove additional nodes, because of scarring/fibrosis caused by the previous axillary surgery. Also, further axillary dissection may lead to lymphedema or other complications. However, please speak to your surgeon again if you need reassurance and satisfactory explanations/answers to all your queries.
Further local (radiation) and systemic (chemotherapy, anti-HER2 therapy if HER2 positive, endocrine therapy if ER positive) treatment is also indicated.
Please relax. I wish you good luck for the upcoming surgery. God Bless!

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