Rejecting surgeon's advice to have axillary nodes removed



i have seen a lot of evidence (Z11 and Baylor for example) that ductal breast cancer has very low inceidence of axillary node metasteces and indicates sentinal node clearence is sufficient when doing a lumpectomy. However most surgeons in the UK want to do axillary clearence. I’m trying to find a sugeon who is happy to do sentinal node and lumpectomy only. Has anyone used this approach or is contemplating doing so and found a willing surgeon?





Hi Chloe ,have you had cancer in your sentinel nodes confirmed ? There was and may still be a clinical trial ongoing at various hospitals in the UK where you are offered alternatives to auxiliary clearance e.g. radiotherapy to the arm pit .My hospital was taking part and I was told they were looking at how effective alternatives to node clearance were.

I’m not sure what your position is? Sentinel node removal only (plus any palpable nodes)  is the approved pathway for anyone believed to be node negative. It gets a lot more complicated if they suspect node involvement. 


My mum had axillary lymph node involvement at diagnosis. They did chemo, a lumpectomy, sentinel node removal (post chemo) then radiation to breast. The lymph nodes that they removed were clear - so they were happy that the chemo had worked and they wouldn’t do axillary clearance due to lympodoema risks. Apparently SNB following chemo has been shown to be as effective. Sadly they took the wrong lymph nodes (original lymph node was found to be present - they chemo had shrunk it)and mums cancer flared back up within a year. It spread rapidly and I lost my mum a year ago.
Sorry for the negative story but I wish my mum had the opportunity for axillary clearance - she may still have been here xx

Hi ,i had my op on sept 13th for stage 1 grade 3 lobular bc ,i opted out of the posnoc trial as up to that point it was believed that my nodes seemed either unaffected or very minimal  and realised that i wouldnt prob need a full clearance , turns out i was right as only the 2 sentinal nodes and 1 other did have cancer in them and were removed .i am having problems with a seroma that is being drained for a 2nd time tommorow but at least they took away the cancer ,i also have to have gene testing on the 10th nov which added to me wanting anything that was found removed asap ,i feel less like a ticking timebomb now?.l would speak to the onc /surgeon about how likely a full clearence would be for you as it poss wont come to that .i realise different bc  approached differently but dont be affraid to ask what is best tailored for you .xx