NCCN Guidelines for Patients® | Stages I and II Breast Cancer - page 30

28
NCCN Guidelines for Patients
®
Stages I and II Breast Cancer, Version 1.2014
3
Surgery/reconstruction Which lymph node surgery should I have?
Which lymph node surgery
should I have?
Deciding factors
Part 2 recommended getting a physical exam and
imaging tests. If these tests do not show cancer in
your axillary lymph nodes, a sentinel lymph node
dissection is recommended. If you had a lymph node
biopsy, described on page 15, a sentinel dissection is
also recommended if no cancer is found. A sentinel
Deciding factors
Should I have a sentinal dissection or an axillary dissection?
Maybe neither, if any of these
factors describe you
• Have tubular or mucinous breast cancer,
• Having lymph node surgery wouldn’t affect chemotherapy or
hormone therapy decisions,
• Are of older age, OR
• Have serious health problems other than cancer
Should I have a sentinel dissection?
Yes, if any of these factors
describe you
• Had no signs of cancer in your nodes as assessed by physical
exam and imaging tests, OR
• Had a lymph node biopsy that didn’t find cancer
Should I have an axillary dissection?
Maybe, if all of these factors
describe you
• Had a sentinel dissection that found cancer and ALL the
following:
• You have cancer in only 1 or 2 nodes,
• You have a breast tumor no larger than 5 cm,
• You will have breast-conserving therapy,
• You will have whole-breast radiation therapy, AND
• You won’t have neoadjuvant chemotherapy
Yes, if any of these factors
describe you
• Had a lymph node biopsy that found cancer,
• Had a sentinel dissection that didn’t find the sentinel node, OR
• Had a sentinel dissection that found cancer plus one or more of
the following:
• You have cancer in 3 or more nodes,
• You have a tumor larger than 5 cm,
• You will have a mastectomy,
• You won’t have whole-breast radiation, OR
• You will have neoadjuvant chemotherapy
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