It depends on stage and grade and size of tumor, etc - but I would absolutely question the surgeon about it. Did she mention Sentinel Node biopsy? Those are smaller, closest to tumor, and less invasive than dissecting axillary nodes. You should just be clear with the doc, and perhaps have a second opinion.

You should insist on sentinel node mapping. You don't want lymph nodes removed unless necessary but you also need to confirm all is clear. Be sure they give you a novicane cream to numb the nipple ahead of time. It works great and makes the procedure practically pain free. If they don't want to do the mapping or just want to take out all the lymph nodes, find someplace else. There are many, many options out there and you might be surprised how affordable. You have to be your own advocate so don't settle for anything less then what you deserve!! Same for reconstruction, nearly all hospitals put in expanders at the time of surgery and it's crazy not to so long as its not medically prohibited. You just have to have a plastic surgeon along side the surgical oncologist. I wasn't happy with the first place I started treatment and was depressed with my surgical options so I checked out another place and didn't like them either. Third place was awesome and they quickly put my mind at ease.
Feel free to contact me if you have any more questions. I'm an old pro at this. I've actually had 3 mastectomies LOL
I certainly wish you all the best.

from my understanding from my breast surgeon, a sentinel node biopsy is always done when mastectomy is performed.

I had DCIS with mastectomy. My surgeon gave me the option of sentinel node biopsy or not. I chose to go ahead with it just for my peace of mind. You will need drains anyway so for me, taking out 1 lymph node was no big deal. I am 4 weeks post surgery and am doing very well @A MyBCTeam Member

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A MyBCTea...

Ask Questions until you know the answers. If you forget to ask, get a notebook and write the questions down. Take notes ifyou need.