Anyone taking part in the SMALL trial

Hello,  I am sorry to hear you are having another go round with breast cancer.  Things have changed in years.

i love in Florida and got diagnosed in 2021 and was 71.  Had DCIS in 1 breast and a small 3 mm ER and PR positive tumor with 6 mm DCIS.  Had lumpectomy on both and radiation.  No lymph nodes removed as I was over 70 and tumor was small.  My surgeon was wonderful and had been involved in clinical trials so up to date.  Also taking aromatase inhibitors for 5 years (ugh).  That is not easy but only a little over a year in these. 
Seems there are trials trying to see if there is a real benefit to removing so many lymph nodes.  

Take care.  Thank goodness there are scientists who are working on these trials.  Here in US many projects were gutted.  

VAR.  vacuum assisted excision is used here but not too many surgeons do it.  Seems like a good option for small tumors.  

Just read about this, for small tumours grade 1?

 Some questions I would ask:  

They biopsy the lymph nodes in your armpit? Will they use dye to find the main lymph node?  How will the  biopsy affect the node? 

I wonder what the clearance is for the removal of the cancer?  I read a larger needle similar to the punch biopsy. 

how will they locate the cancer accurately? When the did my first biopsy, I recall a few of them.  Would that be the same?

what is the typical successful removal with clearance, I’d also ask if they can tell what the clearance was, with this method. 

So sorry to hear you have cancer again. 

Thank you. I have a lot of questions to ask them

They don't biopsy lymph nodes, the procedure is done via ultrasound. Yes with a larger needle like a biopsy.

They said my lymph nodes looked clear on ultrasound. Also on 3d scan.

There is a risk that 1 in 12 would have microscopic cancer left, or in nodes. but radiotheraphy and hormone treatment should clear that up.

Radiotherapy to the whole breast would take place after, including on lymph nodes. 

Then followed by 5 years hormone blockers,  

There's no official data on results as study still ongoing.

The trial has been running since 2019. 

I'm 57 yrs old. Was 43 the first time around.

Surgery worked for me last time, and that breast is still clear. 

Difficult decision, what are the odds for lumpectomy?  1 in 12 is just over 8%.  I don’t know how effective radiotherapy alone is to kill the cancer if it remains or is in the lymph nodes.  Hormone therapy stops it being fed while we take the pills. 

is this secondary or another primary?

It's another primary grade 1,  7mm. 

I Had lumpectomy in opposite breast 15 years ago. They said that I probably didn't need radiotherapy or tamoxifen, and the surgery alone probably cured me, but it was done as precation.

If this had been my 1st cancer, I'd probably have considered the trial(As I wouldn't have known any different)

As it's the 2nd time, it's the stress and worry that they don't get it all.

Thank you, wishing you a speedy recovery 

Hi - I was diagnosed in Jan 2022 and went on the SMALL Trial. Procedure done under local anaesthetic, needle inserted and tumour ‘vacuumed out’ under ultrasound guidance. A little uncomfortable but totally doable, I watched on the screen. Recovery is quick and after 5 days of Radiotherapy and 4 years of Anastrozole I am doing ok (well, got my annual mammogram next week so we’ll see !). I was a little nervous that no lymph nodes are biopsied so always that doubt that there were some rogue cells still lurking, but I would def consider this option.

Good luck whatever you choose.

Thank you. I have actually decided to opt out. 
as this is my 2nd time and I wasn’t comfortable with the answers to my questions, I wish everyone going through this journey a speedy recovery. I’m awaiting a date now for surgery. 

Please can I ask what age you are, thank you