Dis Breast Cancer Survivors Part IV - GAGWTA

Good news! The neurologist agreed to see Kendall. I only spoke to his secretary, but she said he reviewed her records, scans, etc. and said he needs to see her. They had a cancellation, so she has an appointment on Friday. Scary? Yes, but we need to know!
Hoping this goes well for Kendall, Peg. Prayers are with her, and you also.

Prayers and good thoughts are with all the wonderful folks here on this thread. Hoping today is better than yesterday for everyone here, and that tomorrow will even be better than today. :hug:'s
 
got to meet nurse ratchet today....
somehow she's still alive and working in the hospital where i get chemo...
i just don't get it..
we're going through enough stuff as it is...
why is it so important for them to force their will on patients who aren't even asking that much...
all i asked for was the nurse who 3 times has succeeded in starting the IV in my elbow...
it takes him a total of 30 seconds to start an IV and then he can go back to the patients he's been assigned to...
but the head nurse (AKA nurse ratchet) said she's the one for difficult veins...
that she's just as good at the nurse i wanted..
so she brings over the tray of IV stuff... makes one really bad attempt at finding a vein in my elbow (my veins are very deep....but not thin...just very deep....the good nurse has 3 times successfully found a vein in one try...straight in....)
so nurse ratchet, after one failed attempt, she immediately turns to my hand, which is what i was trying to avoid....
the hand hurts like crazy the entire chemo (5 hours long) and continues to hurt for days and weeks...
so she sticks it in my hand all chipper and talkative..
forcing her will on me...when he was right there (the other nurse who's known to be the good one at starting IVs)...the place was empty as lot of patients were late this morning for some reason...
he was available to start it....but no...she had to force her will on me...
and i fought tears the entire 5 hours....probably sounds silly to a lot of people, but i was just so upset i was fighting tears the entire 5 hours of my chemo....the thing is, he was there...sometimes he's not there, and then i'm stuck with whoever, and so that's life and it's going to go into my hand..
and of course, even if he starts it, there is the possibility that he'll also have to use my hand....but at least i'll have had a chance at the elbow...
but she didn't give me that chance....she forced her will on me....
when the social worker who works there came into the chemo area and saw me, she came right over and said is everything ok?
i said i didn't want to talk - i don't like crying in front of people, so i don't like to talk when i know i'll break down and cry...
but she got the story out of me...
she said she knew something was terribly wrong as i'm always so super smiley and friendly and nice and i just looked terrible today...
i'd been happy and smiley when i came in....but that was before nurse ratchet....
the social worker was very upset about it.....but it is what it is..you can't turn back the clock....
having cancer and having to go through all these treatments - you're already so not in control...
other people are in control of your life and you have to go along....and then when someone takes even that last little bit of control/choice away from you, it's just so demoralizing....

anyway, when i was finished and waiting by the appointments desk to arrange for next week, nurse ratchet tried to put her arm around me and i moved sideways out of her reach..
she apologized and i turned to her and said "you raped me".....and walked away.....

i saw my oncologist right after the chemo (i see her every 4 treatments)...
when she found out i'd been crying during chemo she asked why i hadn't said anything..
i didn't tell her....her secretary saw me crying in the waiting room waiting for my Onc appointment and asked if anything was wrong and i said no i'm fine...not to worry...
but she must have told the doc who must have called the treatment center to ask....
so she wondered why she hadn't been informed...
but what was the point? what's done is done....
she told me to ask for the nurse i want to start the chemo next time...to use her name..
but i imagine she's actually going to tell them she doesn't want to hear of someone crying during chemo and her not hearing about it...
she's the head of the entire oncology department....so if she does, perhaps they'll listen..

i hope they're not all pissed off at me next week..

and that's the other problem....you're at their mercy....so if you do say something, who knows how they'll feel...

sort of like sending back a poorly cooked meal....what will the pissed off chef do....which of course is why i never ever ever send back a meal...even if it's entirely inedible.....

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Beth/Disneyholic family, I'm so sorry about the needle stick today. I'd hate having it done in my hand too!! She should have asked if it was okay instead of just forcing it, grrr!!! It does sound like the entire rest of the team really cares about you. I hope and pray next week goes much better, and your favorite nurse is there and available to work with you.
 
Disneyholic, so sorry that happened. I knew I'd never make it through chemo with my veins. After so many years and so many surgeries, they are shot. I am so glad I had a port put in.
 


Well, we saw the neurologist today. She spent two and a half hours with us. Very nice. She was incredibly thorough. Kendall's latest brain MRI was normal. That's good news, except it wasn't done with contrast. The doctor said that there is definitely something going on, but she isn't ready to diagnose without a lot more info. She was amazed that Kendall's other doctors hadn't performed a number of tests. She has ordered another brain MRI with contrast and a thoracic spine MRI with contrast. She ordered a ton of lab tests, including a test for Lyme Disease. She wants to see the results, but said that she will probably send us to a doctor at Shands in Gainsville who specializes in diagnosing difficult cases...think Florida's version of Dr. House. lol. Sadly, before that can happen, I need to change Kendall's insurance again. Shands does not take Kendall's plan. They take Florida Blue, but not that particular plan. It is becoming obvious to me that we need to upgrade. In the long run, I don't mind paying more (I already pay almost $600 a month for her insurance), if means she gets to see the right people. So, we wait again!

Hope everyone is doing well! As always, thinking of you ladies!
 
Well, we saw the neurologist today. She spent two and a half hours with us. Very nice. She was incredibly thorough. Kendall's latest brain MRI was normal. That's good news, except it wasn't done with contrast. The doctor said that there is definitely something going on, but she isn't ready to diagnose without a lot more info. She was amazed that Kendall's other doctors hadn't performed a number of tests. She has ordered another brain MRI with contrast and a thoracic spine MRI with contrast. She ordered a ton of lab tests, including a test for Lyme Disease. She wants to see the results, but said that she will probably send us to a doctor at Shands in Gainsville who specializes in diagnosing difficult cases...think Florida's version of Dr. House. lol. Sadly, before that can happen, I need to change Kendall's insurance again. Shands does not take Kendall's plan. They take Florida Blue, but not that particular plan. It is becoming obvious to me that we need to upgrade. In the long run, I don't mind paying more (I already pay almost $600 a month for her insurance), if means she gets to see the right people. So, we wait again!

Hope everyone is doing well! As always, thinking of you ladies!
Well, at least it's a good start! Glad you've got someone on your side now. Two and a half hours, wow!
 
Well, we saw the neurologist today. She spent two and a half hours with us. Very nice. She was incredibly thorough. Kendall's latest brain MRI was normal. That's good news, except it wasn't done with contrast. The doctor said that there is definitely something going on, but she isn't ready to diagnose without a lot more info. She was amazed that Kendall's other doctors hadn't performed a number of tests. She has ordered another brain MRI with contrast and a thoracic spine MRI with contrast. She ordered a ton of lab tests, including a test for Lyme Disease. She wants to see the results, but said that she will probably send us to a doctor at Shands in Gainsville who specializes in diagnosing difficult cases...think Florida's version of Dr. House. lol. Sadly, before that can happen, I need to change Kendall's insurance again. Shands does not take Kendall's plan. They take Florida Blue, but not that particular plan. It is becoming obvious to me that we need to upgrade. In the long run, I don't mind paying more (I already pay almost $600 a month for her insurance), if means she gets to see the right people. So, we wait again!

Hope everyone is doing well! As always, thinking of you ladies!


sounds like you finally saw someone with a thorough approach....
i'm completely stunned that they did an MRI without contrast - basically a worthless test that still costs a ton of money....
without contrast, they really can't see what they need to see to make any sort of diagnosis...

the differential diagnosis with lyme disease is also what they did with my nephew (of course we were hoping for lyme, but it wasn't...he has MS)....

the american insurance system boggles my mind...i totally don't get it (we don't live in the US)....but good that you're able to navigate and upgrade so that Kendall gets to see who she needs to see!!..

good luck with everything!! it sounds like you're finally seeing the right people and you're moving forward in finding out what the problem is!!
 


so hi again! haven't been around for a month i think...
i'm now in the second phase of my chemo..
i completed the AC stage (AC every 2 weeks for 4 rounds).
and am now in the 12 weekly taxol-carboplatin chemo stage..
i've had 3 of the taxol/carboplatin treatments and have 9 to go...

once those are over, i'll have a one month recovery period and then on to my double mastectomy....and then i suppose radiation after that..

my tumor has definitely responded to the chemo...or at least to the AC (hopefully also to the TC)...
it's shrunk from the giant it was before...so that's good news!!

the chemo has been hard, but i'm ok so far....my biggest issue actually is fear of IV...hahah.....the nurses where i get chemo are not the best at finding veins....and they always opt out for the easy route - my hand (which hurts like hell and destroys them to boot)..
but it turns out one of the nurses is good at finding them, so 3 times i've succeeded in getting the nurse i was assigned to that day to call the expert nurse to start the IV in my elbow rather than my hand...what a relief...but every week now i get nervous worrying he won't be there...
here's hoping he'll be there on tuesday!!!!

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Hi there, I just saw your post. It sounds like you are dealing with Inflammatory Breast Cancer? I was diagnosed with that on Dec 20. I've had 4 rounds of AC and have 12 rounds of TC. I have 4 more rounds of the TC left. Then a 4 week break, Double Mastectomy, then radiation. IBC is so rare, only 2-5% of all breast cancers are IBC. I am also Triple Negative which means none of the hormone receptor drugs will work for me. I just wanted to reach out and say hello. Most of the breast cancer survivors I meet with this type of cancer have this protocol. Most of the tumor type breast cancers get TC only and for a much shorter time... So far I've been very blessed with little to no side effects except neuropathy in feet and hands. I wish you well... I'm going to Disneyland next month during my 4-week break. I'm surprised they didn't insert a port for your chemo. It was mandatory for me. They told me the AC would destroy my veins and literally eat them up alive.
 
Hi there, I just saw your post. It sounds like you are dealing with Inflammatory Breast Cancer? I was diagnosed with that on Dec 20. I've had 4 rounds of AC and have 12 rounds of TC. I have 4 more rounds of the TC left. Then a 4 week break, Double Mastectomy, then radiation. IBC is so rare, only 2-5% of all breast cancers are IBC. I am also Triple Negative which means none of the hormone receptor drugs will work for me. I just wanted to reach out and say hello. Most of the breast cancer survivors I meet with this type of cancer have this protocol. Most of the tumor type breast cancers get TC only and for a much shorter time... So far I've been very blessed with little to no side effects except neuropathy in feet and hands. I wish you well... I'm going to Disneyland next month during my 4-week break. I'm surprised they didn't insert a port for your chemo. It was mandatory for me. They told me the AC would destroy my veins and literally eat them up alive.


Mine is extremely aggressive Triple Negative Invasive Duct Carcinoma.

i was also diagnosed in december (the 13th), but i caught the flu and treatment could only start once i'd recovered (3 week delay)

i now have 5 rounds of TC left...
you're right that those with triple negative are the ones who get carboplatin added to the taxol..

they don't generally put in ports where i live...it's not standard procedure as it is in the USA.

after i finish TC, i have 4 weeks and then the double mastectomy.
my surgery is scheduled for july 2...on july 1st i go in for the sentinel node marking (on the cancer side)..

i'm not having reconstruction..

i don't know yet what radiation i'll have to have...though i assume i will need some on the cancer side (my right side)..

disneyland sounds like a spectacular way to spend the break!!!!!!!!!!!!!!!!!!!!!

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:grouphug: guys. My BC was grade 3, triple negative, too, with two nodes positive - which developed 11 months after a totally negative mammogram, so it was very aggressive, also. Had surgery, AC/T and radiation, as well.

Just as a positive, cause I liked to hear the good stories when I was in the thick of it, I never had a recurrence, knock on wood, in 15 yrs. Hopefully that helps to hear! The reading is terrible that's out there.
 
:grouphug: guys. My BC was grade 3, triple negative, too, with two nodes positive - which developed 11 months after a totally negative mammogram, so it was very aggressive, also. Had surgery, AC/T and radiation, as well.

Just as a positive, cause I liked to hear the good stories when I was in the thick of it, I never had a recurrence, knock on wood, in 15 yrs. Hopefully that helps to hear! The reading is terrible that's out there.


good to hear you haven't had a recurrence!!
mine was also grade 3 and node positive (don't know how many nodes until they take them out in surgery and do the pathology)

it's funny.....they want me to do a lumpectomy....i told them no way, i'm doing a double mastectomy..
they said i can have surveillance on my non-cancer side....really? seriously? surveillance didn't work on the cancer side, so why would they think it will work on the other side??????? or on the lumpectomy side for that matter...
my BC grew so fast it came out of nowhere like wildfire.....gotta get rid of these ticking time bombs..
i know it doesn't reduce the risk to zero, but it does reduce the risk at least somewhat...any reduction in risk is a good thing...

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My friends, I'm back. I had my bilateral mastectomy Tuesday, with no reconstruction. We have a WDW trip planned for early June, and the simple mastectomy option seemed to be a quicker recovery. Plus, I can only deal with so much at one time. Am feeling good, and able to go for walks. Pleasantly surprised at the good range of motion in my shoulders. I can reach upper cupboards, but not the top ones. I find out the results of sentinel node this week, and get drain tubes out. This has really gone so much better than I thought. Very little pain, and after the first day, it has been limited to the incision sites. Thanks for all the well wishes!!! PS, have decided that busy prints, ponchos, and scarves will be my new wardrobe go-tos!! Hugs and prayers to you all!!
 
My friends, I'm back. I had my bilateral mastectomy Tuesday, with no reconstruction. We have a WDW trip planned for early June, and the simple mastectomy option seemed to be a quicker recovery. Plus, I can only deal with so much at one time. Am feeling good, and able to go for walks. Pleasantly surprised at the good range of motion in my shoulders. I can reach upper cupboards, but not the top ones. I find out the results of sentinel nodeced this week, and get drain tubes out. This has really gone so much better than I thought. Very little pain, and after the first day, it has been limited to the incision sites. Thanks for all the well wishes!!! PS, have decided that busy prints, ponchos, and scarves will be my new wardrobe go-tos!! Hugs and prayers to you all!!

Best of luck. You have a great outlook and embracing this. Wanted to say that a friend of mine went the same route...double mastectomy with no reconstruction 10 years ago. Fully embraced her choice and never looked back. It’s not for everyone and no right or wrong.

I wanted my mom to get a mastectomy when she first had breast cancer. She opted for lumpectomy, chemo and radiation. 12 yers later the cancer came back and she had to have a mastectomy. I wanted her to have double but she wasn’t having any of it. Point being, it is all a personal choice.
 
good to hear you haven't had a recurrence!!
mine was also grade 3 and node positive (don't know how many nodes until they take them out in surgery and do the pathology)

it's funny.....they want me to do a lumpectomy....i told them no way, i'm doing a double mastectomy..
they said i can have surveillance on my non-cancer side....really? seriously? surveillance didn't work on the cancer side, so why would they think it will work on the other side??????? or on the lumpectomy side for that matter...
my BC grew so fast it came out of nowhere like wildfire.....gotta get rid of these ticking time bombs..
i know it doesn't reduce the risk to zero, but it does reduce the risk at least somewhat...any reduction in risk is a good thing...

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I would feel the same way. My friends oncologist told her that double mastectomy is still no guarantee but didn’t talk her out of it. 2 years later oncologist wound up with breast cancer and had a double mastectomy
 
good to hear you haven't had a recurrence!!
mine was also grade 3 and node positive (don't know how many nodes until they take them out in surgery and do the pathology)

it's funny.....they want me to do a lumpectomy....i told them no way, i'm doing a double mastectomy..
they said i can have surveillance on my non-cancer side....really? seriously? surveillance didn't work on the cancer side, so why would they think it will work on the other side??????? or on the lumpectomy side for that matter...
my BC grew so fast it came out of nowhere like wildfire.....gotta get rid of these ticking time bombs..
i know it doesn't reduce the risk to zero, but it does reduce the risk at least somewhat...any reduction in risk is a good thing...

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I had similar choices and I went with the lumpectomy. My (Harvard Medical School professor) surgeon explained to me, and I researched, that the type of surgery I chose wouldn't determine whether I'd live or die from this disease. :guilty: There were other reasons, too - I was working and had to figure in all the time off I was taking, I had two young children, risks of more involved surgery, etc. But it's been a good choice for me. My original cancer, they say, is gone and likely won't recur now (after 15 yrs); my risks of getting another cancer are the same as anyone else's. Should that occur then I'll have more choices to make.

I was reading an article recently about the "Angelina Jolie effect" which basically stated that they are probably doing more double mastectomies now than are needed as people think it's going to be "better". But one really needs to do a lot of research for themselves to figure out exactly what the actual statistics say, and then decide what works best for them. Last I read, which was about several months ago, lumpectomy had similar survival rates to mastectomy for certain/many cancers and situations. If it's given as an option, than it's a good one to think about.

ETA people should also understand that recurrences can happen even with mastectomy because breast tissue extends down to under the arm and above the clavicle in some cases, so it's impossible to remove all of it. One of our posters here, Feralpeg, had cancer in her surgical mastectomy scar.

I am replying to this post above, but I'm also saying this for the people reading here. Knowledge is power, and it's good to have all the facts.
 
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I had similar choices and I went with the lumpectomy. My (Harvard Medical School professor) surgeon explained to me, and I researched, that the type of surgery I chose wouldn't determine whether I'd live or die from this disease. :guilty: There were other reasons, too - I was working and had to figure in all the time off I was taking, I had two young children, risks of more involved surgery, etc. But it's been a good choice for me. My original cancer, they say, is gone and likely won't recur now (after 15 yrs); my risks of getting another cancer are the same as anyone else's. Should that occur then I'll have more choices to make.

I was reading an article recently about the "Angelina Jolie effect" which basically stated that they are probably doing more double mastectomies now than are needed as people think it's going to be "better". But one really needs to do a lot of research for themselves to figure out exactly what the actual statistics say, and then decide what works best for them. Last I read, which was about several months ago, lumpectomy had similar survival rates to mastectomy for certain/many cancers and situations. If it's given as an option, than it's a good one to think about.

ETA people should also understand that recurrences can happen even with mastectomy because breast tissue extends down to under the arm and above the clavicle in some cases, so it's impossible to remove all of it. One of our posters here, Feralpeg, had cancer in her surgical mastectomy scar.

I am replying to this post above, but I'm also saying this for the people reading here. Knowledge is power, and it's good to have all the facts.


yes, everything you say is true...for an existing cancer, the outcome is the same whether you have a lumpectomy or mastectomy...
however, the reason for removing the "healthy" breast is not risk of a recurrence but the risk of a new cancer...
in my case, the cancer is most likely hereditary (every woman on my mother's side of the family for at least 4 generations has had breast cancer at some point - and most have died from it - like my cousin a month ago)..

of course, with hereditary cancer, the only 'recognized' mutations for which prophylactic mastectomy is recommended are on the BRCA1 and BRCA2 genes...
since with mutations on those genes, the risk of occurrence or recurrence is sky high....

i don't have a BRCA mutation (my sister does, but i don't)...
however, i do have two other mutations that aren't known to be related to breast cancer (they're known to be related to colon cancer)..
the genetics specialist dealing with our family believes there must be a third mutation that currently is unknown....not all gene mutations are yet known....he says that with the rate of occurrence of cancer in my mom's family there must be a mutation that just isn't known yet and so cannot be tested as yet..

to not take any of that into account when i'm making a decision regarding surgery is just ignoring the writing on the wall...
 
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actually the thing i'm really confused about right now is axillary node dissection...
i don't know what to do...
i don't know the pros and cons...
backing up...
this is referring to the cancer side - not the healthy side..

they will do a sentinel node biopsy on the cancer side....
but they'll do the pathology while i'm still in surgery (while i'm still asleep)..
i don't remember what he said - but based on a given finding in the pathology, they will do a first and second level axillary node dissection right at the same time as the mastectomy given the outcome of the sentinel node biopsy...

so the question i have - and it only came to me after we left the surgeons office:
can i wait to have the axillary node dissection at a later date?
that is, do it in two steps rather than one step?

and what is the theory behind each method? having it at the same time as the mastectomy or later...

i have to try to find out before the surgery !! :)
 
yes, everything you say is true...for an existing cancer, the outcome is the same whether you have a lumpectomy or mastectomy...
however, the reason for removing the "healthy" breast is not risk of a recurrence but the risk of a new cancer...
in my case, the cancer is most likely hereditary (every woman on my mother's side of the family for at least 4 generations has had breast cancer at some point - and most have died from it - like my cousin a month ago)..

of course, with hereditary cancer, the only 'recognized' mutations for which prophylactic mastectomy is recommended are on the BRCA1 and BRCA2 genes...
since with mutations on those genes, the risk of occurrence or recurrence is sky high....

i don't have a BRCA mutation (my sister does, but i don't)...
however, i do have two other mutations that aren't known to be related to breast cancer (they're known to be related to colon cancer)..
the genetics specialist dealing with our family believes there must be a third mutation that currently is unknown....not all gene mutations are yet known....he says that with the rate of occurrence of cancer in my mom's family there must be a mutation that just isn't known yet and so cannot be tested as yet..

to not take any of that into account when i'm making a decision regarding surgery is just ignoring the writing on the wall...
Yes, being gene positive would definitely influence that decision.

actually the thing i'm really confused about right now is axillary node dissection...
i don't know what to do...
i don't know the pros and cons...
backing up...
this is referring to the cancer side - not the healthy side..

they will do a sentinel node biopsy on the cancer side....
but they'll do the pathology while i'm still in surgery (while i'm still asleep)..
i don't remember what he said - but based on a given finding in the pathology, they will do a first and second level axillary node dissection right at the same time as the mastectomy given the outcome of the sentinel node biopsy...

so the question i have - and it only came to me after we left the surgeons office:
can i wait to have the axillary node dissection at a later date?
that is, do it in two steps rather than one step?

and what is the theory behind each method? having it at the same time as the mastectomy or later...

i have to try to find out before the surgery !! :)
It makes most sense to have it done then and there because you are already sedated and prepped and all the players are in place - including the surgeon and the pathologist. What happens is that the surgeon removes the sentinel node and hands if off to the pathologist. The pathologist checks it for signs of cancer while the sugeon continues on doing surgery. If the pathologist finds no signs of cancer in the node, that's done. If there is cancer, the surgeon goes back in and takes out more that are nearby, then they are sent to pathology lab where they are all studied using a longer process that could take more than a few days. My sentinel node was positive, so my sugeon removed eight, total. I found out at my two week post-surgical check that two were positive - until then I only knew that the sentinel node was positive. So waiting will cause a much more drawn out process because it will require an additional procedure and more waiting. Hope that helps.
 
ok...so i just read 10 medical journal articles on the subject and i finally kind of sort of understand..
so the issue is positive vs negative cancer in the sentinel nodes...
the confusion is after neoadjuvant chemo, there can be false negative results from the sentinel node biopsy...
i'll have a chit chat with the oncologist about this..

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Yes, being gene positive would definitely influence that decision.


It makes most sense to have it done then and there because you are already sedated and prepped and all the players are in place - including the surgeon and the pathologist. What happens is that the surgeon removes the sentinel node and hands if off to the pathologist. The pathologist checks it for signs of cancer while the sugeon continues on doing surgery. If the pathologist finds no signs of cancer in the node, that's done. If there is cancer, the surgeon goes back in and takes out more that are nearby, then they are sent to pathology lab where they are all studied using a longer process that could take more than a few days. My sentinel node was positive, so my sugeon removed eight, total. I found out at my two week post-surgical check that two were positive - until then I only knew that the sentinel node was positive. So waiting will cause a much more drawn out process because it will require an additional procedure and more waiting. Hope that helps.


the surgeon said that if it's positive, he'll do a complete axillary node dissection of the 1st and 2nd level....in other words, remove all of them at those two levels...not just a few, but all of them...
i'm meeting with the oncologist after my chemo next tuesday, so i'll ask her then....
the surgeon said this is the standard procedure used at sloan kettering, which is where he trained...
as i mentioned above, i just read way too many medical journals (basically reviews of clinical trials and views about sentinel node biopsy and axillary node dissection in patients with imflammatory breast cancer and neoadjuvant chemotherapy...)
and of course, as often happens, when you read 10 articles you get 10 slightly different opinions...oops...
so i'll see what the oncologist has to say..

and to clarify....i'm no longer talking about delayed vs immediate....i'm talking about whether to do the 1st and 2nd level axillary node dissection as stated by the surgeon...
 

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