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Next steps after positive sentinel node?

Page last modified on: November 20, 2008
Question from MiasMom: I thought I was having a sentinel node biopsy, but after doing it, my doctor found positive lymph nodes and did a standard lymph node dissection. Was this necessary?
Answers —Generosa Grana, M.D., F.A.C.P.: The traditional approach to a woman who has a positive sentinel node is to remove additional nodes so that one can determine the true extent of disease, get a better handle on prognosis, determine what kind of chemotherapy to use, and determine whether the axilla [underarm] and supraclavicular [over the collarbone] area need to be irradiated.

Data was presented that if you have a microscopically positive sentinel node, dissecting the axilla was helpful in making decisions about outcome and treatment. Studies are being done to ask whether the best way to manage the axilla in a woman with a positive sentinel node is to remove it or irradiate it.
Marisa Weiss, M.D., president and founder: At this time, if you have a positive sentinel lymph node, additional surgery is recommended in order to determine outlook/prognosis as well as to guide appropriate effective therapies. One study showed that for women who had only a few cells in the sentinel lymph node that were detected only by special stains and the traditional lymph nodes were free and clear, that woman's outlook proved to be the same as the woman who had no lymph node involvement. But if a woman was found to have collections of cells in her sentinel lymph nodes that were discovered by traditional testing methods (H&E staining), that finding did have an impact on prognosis. That type of situation is considered more serious than women without lymph node involvement.

On Wednesday, December 21, 2005, our Ask-the-Expert Online Conference was called Updates from San Antonio Breast Cancer Symposium 2005. Generosa Grana, M.D., F.A.C.P. and moderator Marisa Weiss, M.D. brought you the highlights of the 2005 Breast Cancer Symposium and answered your questions about the latest diagnostic and treatment options for breast cancer.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Generosa Grana, M.D., F.A.C.PGenerosa Grana, M.D., F.A.C.P. is the director of the Cooper Cancer Institute and heads the division of hematology/medical oncology at Cooper University Hospital.

Marisa Weiss, M.D. is a radiation oncologist specializing in breast cancer and the founder, president, and guiding force behind Breastcancer.org.

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