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ALND vs SLB with radiation - trying to understand which one is better

A MyBCTeam Member asked a question 💭
Houston, TX

When would a full ALND be needed vs just SLB with radiation? My doc is not explaining this. Different doc said no one does ALND anymore, only SLB with rad. Appreciate any advice on this, especially in context of SLB sometimes giving false negative for lobular due to micromets

January 17, 2024
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A MyBCTeam Member

ALND axillary lymph node dissection (removing a large number lymph nodes under the arm pit, when it is known there is cancer in the lymph nodes). SLND sentinel lymph node dissection (taking the first few lymph nodes off the breast to see if there is any cancer there)

January 18, 2024
A MyBCTeam Member

ALND is not done very often. I have only seen it done for LN+, when the person declines chemo before surgery.

January 17, 2024
MyBCTeam

When comparing Axillary Lymph Node Dissection (ALND) and Sentinel Lymph Node Biopsy (SLNB) with radiation for breast cancer, here are some key points from the knowledge base:

Sentinel Lymph Node Biopsy (SLNB)
- Procedure: Involves injecting a colored dye or radioactive substance near the tumor to identify and remove the Show Full Answer

When comparing Axillary Lymph Node Dissection (ALND) and Sentinel Lymph Node Biopsy (SLNB) with radiation for breast cancer, here are some key points from the knowledge base:

Sentinel Lymph Node Biopsy (SLNB):
- Procedure: Involves injecting a colored dye or radioactive substance near the tumor to identify and remove the sentinel nodes for cancer checking.
- Extent: Most nearby lymph nodes are left in place.
- Purpose: Helps determine if cancer has spread to the lymph nodes.

Axillary Lymph Node Dissection (ALND):
- Procedure: Involves removing more lymph nodes from the underarm area, sometimes up to 40, but usually fewer than 20.
- Extent: More extensive than SLNB.
- Purpose: Recommended if previous tests show cancer cells in the lymph nodes to prevent further spread.

Radiation Therapy:
- Usage: Often used after surgery (lumpectomy or mastectomy) to eliminate remaining cancer cells.
- Benefits: Improves survival rates and helps prevent cancer recurrence.
- Side Effects: Can include fatigue, swelling, heaviness in the treated breast, and skin damage similar to sunburn. These effects are usually short-term but can last up to two years.

Considerations:
- SLNB: Less invasive, fewer lymph nodes removed, potentially fewer side effects.
- ALND: More comprehensive, recommended if cancer is detected in lymph nodes, higher risk of side effects due to more extensive removal.

Conclusion:
The choice between ALND and SLNB with radiation depends on individual circumstances, such as the presence of cancer in the lymph nodes and the extent of cancer spread. Consulting with a healthcare provider is essential to determine the best approach for each specific case.

July 15, 2024
A MyBCTeam Member

So if I understand correctly - ALND used to be very common until they did this "Z011" trial which showed that women who had lumpectomy + rad had same survival as those who had lumpectomy + ALND. It looks like that study only tracked women for 6 years tho? and they were nearly all postmenopausal. I wonder how they really know that Rad is equal to ALND for getting rid of mets, especially micromets, to the nodes.

January 18, 2024
A MyBCTeam Member

ALND really pushes one towards lymph edema

January 17, 2024

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