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34

NCCN Guidelines for Patients

®

Breast Cancer - Early-Stage

(STAGES I AND II)

, Version 1.2016

3

Breast cancer surgery

Lymph node surgery

Lymph node surgery

During the breast cancer surgery, axillary lymph

nodes are often removed for cancer testing.

By doing so, the cancer stage can be revised if

needed. You are more likely to receive the best

treatment when the cancer stage is correct.

Figure 3.2

shows the two types of lymph node

surgeries

.

You may have one or both surgeries. It

mainly depends on your results from the needle

biopsy described in Part 2.

Chart 3.2

lists options for lymph node surgery.

Some women may not need lymph node surgery

because it likely wouldn’t extend their life (survival).

Such women include those with slow-growing

cancers (tubular and mucinous breast cancers),

set plans for adjuvant treatment, older in age, or

those with major health problems other than breast

cancer.

Chart 3.2 Treatment options

Type of surgery

Deciding factors

No lymph node surgery

may be an option if

any

of

these factors describe you

Ü

• Have tubular or mucinous breast cancer,

• Will have adjuvant treatment no matter what the results of

lymph node surgery would be,

• Are of older age, or

• Have major health problems other than breast cancer.

Sentinel lymph node

biopsy

is an option if

any

of

these factors describe you

Ü

• Had a physical exam and imaging tests that showed no

signs of cancer in your nodes, or

• Had a FNA or core biopsy that found no cancer in nodes.

Axillary lymph node

dissection

is an option if

any

of these factors describe you

Ü

• Had a physical exam or imaging test after neoadjuvant

treatment that showed signs of cancer in your nodes,

• Had an FNA or core needle biopsy that found cancer in

your nodes and didn’t have neoadjuvant treatment,

• Had a sentinel biopsy that didn’t find the sentinel node, or

• Had a sentinel biopsy that found cancer in your lymph

nodes plus one or more of the following:

o

You have cancer in 3 or more nodes,

o

You have a breast tumor larger than 5 cm,

o

You will have a mastectomy,

o

You won’t have whole-breast radiation, or

o

You will have neoadjuvant chemotherapy.