Lump on the inner portion of the breast?

PaminFL

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ritajean

Hi Pam,

I don't know if I can actually answer your question, but my tumor was in the inner part of the left breast, very near the cleavage area.  I had a lumpectomy and 33 rads.  On the day of my lumpectomy, they performed the sentinal node biopsy.  I asked if the sentinel node would be located in my chest since my tumor was so close to those nodes.  The surgeon told me that in most cases it would still be under the arm, based upon the route that the lymph travels through the system. 

When she performed the surgery, she did indeed find the sentinal node under my arm and removed it as well as three more random nodes.  I was lucky as none of them showed malignancies.

I just celebrated my two year mark, so I'm not a long term survivor, but perhaps the info I received about the sentinal nodes will ease your mind a bit.  I know how these questions and nagging doubts can upset us.

Hang in there!  We've all been scared!  I get scared and nervous before each routine check-up.  Pretty silly, eh, since we certainly don't need the stress???

I wish you the best with the rads.  For me, the rads were a piece of cake after the chemo! 

Rita

Brenda_R

I can also speak to this. My tumor was also located at the 2 to 3 o'clock area of my right breast.

I had a lumpectomy, chemo and rads. They also told me the IM nodes can't be removed. However, I already knew before surgery, that I had a positive IM node in the center of my chest. It showed up on the pet/ct scan I had before surgery. It was treated with specialy targeted rads, and the chemo. A follow up scan showed the node had shrunk.

The little bit of info I've found on positive Im nodes, indicates a worse prognosis,  BUT I can tell you that in my experience, it can be overcome. I am currently NED. Not long term, I was dx'ed at amost the same time as Rita. It's been 2 years for me too.

However, I just recently read that the IM node chain CAN contain the sentinal node for centraly located BC, as I suspected.

Personaly, I would ask for pet/ct scan. It will show if anything is there.

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copy from Asco/ Leeds paper --

//The clinical significance of intramammary lymph node metastases has been largely overlooked in the past. An understanding of their prognostic significance in breast cancer may help to improve pre-operative detection in the future.

Their detection is important for accurate staging and appropriate treatment of breast cancer patients in the adjuvant setting. With the increasing use of sentinel lymph node biopsy and lymphoscintigraphy it is likely that intramammary nodes will be increasingly identified as the sentinel node. The presence of metastases within it has been shown to predict for further axillary disease and axillary dissection should be undertaken.//

credits-

B.V. Hogan1, M.B. Peter1, H.G. Shenoy1, F.E. Langlands1, K. Horgan1 , A.M. Shaaban2

1. The Breast Unit, Dept. of General Surgery, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX2. Department of Histopathology and Molecular Pathology, St. James University Hospital, Leeds, LS9 7TFCorrespondence : B Hogan, Research Fellow in Breast Surgery, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, United Kingdom. Tel : +44(0)7884355150 Fax : +44(0)1133922209 e-mail:bvhogan@yahoo.co.uk

ritajean

O.K. Brenda, now you have me wondering if I should request scans when I go back in March.  My surgeon said my sentinel node was under the arm.  Would she have known for sure when she removed them?  Do you think this dye shows up in the IM nodes, too?  Surely it must or how would they know that the sentinel node is sometimes found there?  There's always questions, isn't there?

Thanks for posting this info.

Rita

Brenda_R

Rita, I went back and looked at my path report and it did identify 2 nodes taken from under the arm, that were blue dye stained. They indentified one as the sentinal node.

I had no positive nodes from those taken from under my arm, but I did have the positive IM node, which in my opinion was my true sentinal node. They never biopsied it since they already knew it was positive on both pet and ct scans. 

If I were either of you, I would see about having at least a ct scan of those chest nodes.  How else would they know they were positive? 

Rita, you probably had a ct scan before rads. I know my rad onc sends everyone for scan before he starts rads. You could get a copy and have it checked to see if it showed anything. It would save you from getting a scan. 

Hope this helps. It irritates me that the doctors don't check these things. Like I said I would never have known, and wouldn't gotten those targeted rads. 

obbosmel

my lump was also on the inner right breast.  Had my SNB and they removed three nodes from under my arm, all negative