Sentinel lymph node biopsy and micromet controversy

Back in March 2005, my Sentinal Node Biopsy (SNB) produced two nodes with small evidence of melanoma, making me stage III.  My doctor asked me if I wanted to participate in a "study."  While I could proceed to have a total lymph node dissection (LND) (left underarm, axilla), this study was to validate ( as best as I can recall) was noted, that 80% of the time, total LND revealed no additional melanoma.   I'm sure he added more to this, more that I did not understand at the time, about survival rates not being increased by having  LND, vs. survival rates for those having jsut a SNB.   I was advised that I would be monitored via ultra-sound (U/S), quite routinely,  as I recall having at least 3 of them done.   I trusted my doctor, felt assured with being monitored.  The last U/S detected one lymph node to be in the size parameters that my oncologist recommended to do a LND in October 2005.   That node and the other 27 removed had no evidence of melanoma!!

I hope this, probably, over-simplified explanation of my situation helps you partially understand some of this link.

FYI, since that time, I developed recurrences ON my left breast (onset Oct 2007)  After several excissions, I ultimately had my left breast removed (which confuses the heck out of everyone, preferring to think I had "breast" cancer…sigh….) in May 2008.   I have been blessed to be NED since that date.   I did not do any adjuvant therapy (interferon or radiation).  And I am not shy to correct the misconception, that I HAVE melanoma, NOT breast cancer.

CarolA

Too many people lisstened to Dr Oz name cancers by where they are located, not by the actual type they are.  People used to ask me about my LUNG cancer.  EDUCATION!

Too many people lisstened to Dr Oz name cancers by where they are located, not by the actual type they are.  People used to ask me about my LUNG cancer.  EDUCATION!

Too many people lisstened to Dr Oz name cancers by where they are located, not by the actual type they are.  People used to ask me about my LUNG cancer.  EDUCATION!

Good explanation, Carol. Thank you. 

Yes, WLE plus sentinal node biopsy is necessary. But going on to remove dozens or scores of lymph nodes "just in case"? With the associated pain, scaring, lymphedema, and damage to the immune system? That is what is under dispute. 

This reminds me that for years US surgeons insisted on doing radical mastectomies "just in case" when Canadian and European surgeons had switched to lumpectomies. Finally, 15 years later, US surgeons decided that lumpectomies plus close follow-up was the better choice in most cases.

Good explanation, Carol. Thank you. 

Yes, WLE plus sentinal node biopsy is necessary. But going on to remove dozens or scores of lymph nodes "just in case"? With the associated pain, scaring, lymphedema, and damage to the immune system? That is what is under dispute. 

This reminds me that for years US surgeons insisted on doing radical mastectomies "just in case" when Canadian and European surgeons had switched to lumpectomies. Finally, 15 years later, US surgeons decided that lumpectomies plus close follow-up was the better choice in most cases.

Good explanation, Carol. Thank you. 

Yes, WLE plus sentinal node biopsy is necessary. But going on to remove dozens or scores of lymph nodes "just in case"? With the associated pain, scaring, lymphedema, and damage to the immune system? That is what is under dispute. 

This reminds me that for years US surgeons insisted on doing radical mastectomies "just in case" when Canadian and European surgeons had switched to lumpectomies. Finally, 15 years later, US surgeons decided that lumpectomies plus close follow-up was the better choice in most cases.

Back in March 2005, my Sentinal Node Biopsy (SNB) produced two nodes with small evidence of melanoma, making me stage III.  My doctor asked me if I wanted to participate in a "study."  While I could proceed to have a total lymph node dissection (LND) (left underarm, axilla), this study was to validate ( as best as I can recall) was noted, that 80% of the time, total LND revealed no additional melanoma.   I'm sure he added more to this, more that I did not understand at the time, about survival rates not being increased by having  LND, vs. survival rates for those having jsut a SNB.   I was advised that I would be monitored via ultra-sound (U/S), quite routinely,  as I recall having at least 3 of them done.   I trusted my doctor, felt assured with being monitored.  The last U/S detected one lymph node to be in the size parameters that my oncologist recommended to do a LND in October 2005.   That node and the other 27 removed had no evidence of melanoma!!

I hope this, probably, over-simplified explanation of my situation helps you partially understand some of this link.

FYI, since that time, I developed recurrences ON my left breast (onset Oct 2007)  After several excissions, I ultimately had my left breast removed (which confuses the heck out of everyone, preferring to think I had "breast" cancer…sigh….) in May 2008.   I have been blessed to be NED since that date.   I did not do any adjuvant therapy (interferon or radiation).  And I am not shy to correct the misconception, that I HAVE melanoma, NOT breast cancer.

CarolA

Back in March 2005, my Sentinal Node Biopsy (SNB) produced two nodes with small evidence of melanoma, making me stage III.  My doctor asked me if I wanted to participate in a "study."  While I could proceed to have a total lymph node dissection (LND) (left underarm, axilla), this study was to validate ( as best as I can recall) was noted, that 80% of the time, total LND revealed no additional melanoma.   I'm sure he added more to this, more that I did not understand at the time, about survival rates not being increased by having  LND, vs. survival rates for those having jsut a SNB.   I was advised that I would be monitored via ultra-sound (U/S), quite routinely,  as I recall having at least 3 of them done.   I trusted my doctor, felt assured with being monitored.  The last U/S detected one lymph node to be in the size parameters that my oncologist recommended to do a LND in October 2005.   That node and the other 27 removed had no evidence of melanoma!!

I hope this, probably, over-simplified explanation of my situation helps you partially understand some of this link.

FYI, since that time, I developed recurrences ON my left breast (onset Oct 2007)  After several excissions, I ultimately had my left breast removed (which confuses the heck out of everyone, preferring to think I had "breast" cancer…sigh….) in May 2008.   I have been blessed to be NED since that date.   I did not do any adjuvant therapy (interferon or radiation).  And I am not shy to correct the misconception, that I HAVE melanoma, NOT breast cancer.

CarolA