Sentinel node biopsy

michele54

I'm not sure if this is the right forum for this but I'm having a sentinel node biopsy in two weeks and was wondering what to expect.  I've started neoadjuvent chemo - have ILC and since ILC spreads out instead forming a lump, they can't really tell how big the cancer is.  According to my oncologist, the area was already shrinking after one treatment and I just had my second.

I've read posts about nodes being removed during surgery but can't find much about a pre surgery - just for diagnosis biopsy.  Is this a normal procedure and what can I expect since it's the only thing they are doing to me.  The nurse said they would knock me out - will I have to stay in the hospital overnight or is it usually an outpatient procedure.  What about pain - if it's only sentinel I'm guessing they will just be removing a node or two.  And how long should I be out of work?  I am very nervous about this.........................

Thanks, Michele

Texas357

I had my sentinel node biopsy simultaneous with the mastectomy and tissue expander insertion. I can honestly say that, for me, the sentinal node area didn't hurt at all. The area was numb, but I'm not sure if that's because of the nerves removed during the mastectomy or if that's also something that happens just with an SNB.  

I don't know what kind of work you do, but I was back at work after all of the above within 4 days.

(I'm told I was not happy when they injected the isotope, but I don't remember any of that because they'd already given me a sedative and I was mentally in "la la" land.)   I'd call your doctor's office and ask specific questions about how they do the procedure. They should at least be able to tell you if it is outpatient or if you should plan on an overnight stay.

I don't think the doctor can't tell ahead of time exactly how many nodes he'll remove because some are very tiny. But someone on my medical team told me that 10 is a good diagnostic number. I had 13 removed.

tabby

Hi Michelle:  Just had the sentinel node mapping yesterday (4-8). The day before I had to go to radiology and have radioactive material put into my breast then come back in about 3 hours and take more pictures (they had me on a table sort of like the MRI where they can move you up and down and then move these "plates" around you to take all sorts of pictures).  My surgery was outpatient.  I am sore today under my arm and my arm tingled yesterday and a little today, sort of like it's asleep.  I'm told this is normal.  You will have to take precautions for the arm to reduce your risk of developing lymphodema such as not doing anything heavy duty and trying not to do anything to develop infection.  My surgeon was able to freeze the section and tell me preliminarily that my nodes were clear although I will have to wait until Tuesday for the final report.  I too, have been diagnosed with ILC as will as LCIS.  I am planning on doing bilateral masectomies soon.  My surgeon wanted to do the nodes first.  Best of luck to you.  It was not a hard surgery and the pain isn't bad--just hard to take it easy and not be anal about using the arm at all!  Tabby

michele54

Thanks for the update Tabby - were you awake or was it done under general anesthesia?  Do you know know many nodes they removed  - I hear the sentinel node isn't always just one node.  I'm thinking of having it done the Tuesday after my next Taxol tx.  Between tx, the Neuasta shot, and the sentinel node biopsy - I figured I would just take the whole week off from work and be miserable.  Do you think that would be too much stress on my system?

Beesie

Michele,

The number of sentinel nodes varies by individual.  The sentinel node is the node that is the "guard" of the lymph node system.  It's the first node - the one that everything that enters the lymphatic system enters through.  When the dye is injected into the breast prior to the SNB, it's intentionally put into several different locations.  The objective is to see which node the dye moves to as it travels through the breast and then moves into the lymph nodes.  If the dye from all the injections move to the same node, then there is one clear sentinel node - one guard that receives everything that enters the nodal system.  Sometimes the dye moves to a couple of different nodes, in which case it's considered that there are two sentinel nodes.  In a small number of cases, each of the injections moves to a completely different node; this means that there is no sentinel node.  Once the sentinel node(s) is identified, some surgeons choose to remove only that node while other surgeons choose to removed the sentinel node(s) and the one or two nodes that line up right behind the sentinel node.  In those few cases where no sentinel node can be identified, the surgeon cannot do an SNB and instead has to do an axillary node dissection, removing all of the nodes in the first line of nodes and possibly some in the second line.

So the number of nodes removed during an SNB can range from 1 node to 4 or 5 nodes, depending on the dye and depending on the surgeon. 

idaho

I had a lumpectomy and SNB at the same time.  The SNB incision bothered me the most, but it was livable.  It was just sore for a few days,  Nothing horrible.  Good luck!  Tami

nancypat

Hi Michele,

Glad to hear your tumors are shrinking. I have to agree with idaho.  My SNB incision did bother me more than the lumpectomy.  I'm allergic to anything narcotic so I got by on just Tylenol.  Be careful about the third day.  I was doing so well that I kind of overdid it so I had more pain on the third day but after slowing down, I did fine.  Best wishes to you.

Nancy