Management of the Axilla in Breast Cancer Flashcards
What is the size of macrometastases in breast lymph nodes?
> 2mm, N1
What is the size of micrometastases in breast lymph nodes?
0.2-2 mm, N1mic
What is the size of isolated tumor cells when staging breast cancer?
<0.2 mm, NO[i+]
Can you do a repeat SLNBx after prior SNBx or dissection?
Yes, with lower rates of success. But the results are reliable if a new SLN is identified.
Why is SLNBx contraindicated in patients with inflammatory breast cancer?
SLNBx results are unreliable. Suspect that lymphatic tumor deposits imede dye mapping.
When is a completion axillary dissection indicated following a SLNBx?
When a patient has either macro- or micrometastatic disease. Not for isolated tumor cells
When is axillary XRT a reasonable alternative to axillary dissection?
In pts whose nodal pathology results will not change treatment plans
A standard axillary dissection takes out what levels of LNs?
Levels I and II
When is an axillary level III dissection performed?
Only whne palpable nodes are present.
Why is a level III axillary dissection typically not done?
Increased risk of lymphadema
How does aggressive post-op pain control facilitate a decrease in morbidity following an axillary dissection?
Pain releife facilitates early post-op mobilization of the arm -> hopefully results in reduced shoulder stiffness and lymphedema
Following axillary dissection, lymphedema occurs in what % of patients?
How many Gy are given for axillary XRT following an axillary dissection?
45-50. Given daily in 1.8-2 Gy fractions
What is the rate of brachial plexus injury after axillary XRT?
What is the rate of lymphadema following an axillary dissection and XRT?