How do you address the axilla in an incidentally found T1bNx invasive breast cancer with extensive DCIS on bilateral prophylactic mastectomy in BRCA-2 mutated woman?
The patient is in her 40s with a BRCA-2 mutation and underwent bilateral prophylactic nipple-sparing, skin-sparing mastectomy. No sentinel nodes were taken. What (if anything) should be done to address the right axilla?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · University Hospitals Seidman Cancer Center
Answered on
I would send her for an axillary ultrasound and biopsy any suspicious lymph nodes. Following a mastectomy, it is challenging to do a sentinel lymph node biopsy so surgical evaluation of the axilla usually requires an ALND. If by imaging the axilla is negative, I would run her tumor characteristics t...
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Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
If systemic treatment, would change because of nodal status, would favor an attempt to SNLN or ALND. If no change, then would favor no additional treatment to axilla.
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