ITC in Sentinel node

Carola32

Hello ladies!

Last week my pathology report came back from a lumpectomy and sentinel node biopsy, initially negative, but apparently there were some isolated tumor cells found in the sentinel node.

In France, clinically I am N-, Pn0(i+) but this is debated. I have an appointment tomorrow with my surgeon, to discuss whether I really need to have a full axillary node dissection or if my scheduled 8 weeks of radiotherapy will do the trick. They will do onco type tests, hopefully I'll know my type tomorrow if all goes well.

The thing is that I've had neo-adjuvant chemotherapy that worked 45% (FEC & Taxotere), and one of the million dollar questions is of course whether the chemo has helped destroy clusters or tumors in my nodes, rendering the path report unreliable. In the beginning of chemo they punctioned one node that was quite swollen (due to different biopsies they thought), turned out negative. 

Has anyone experienced this? Any advice or things to think about for tomorrows rendez-vous? 

Thank you for your answers. 

HelenaJ

Hi Carola30, You have probably already been to your appointment but as you can see from my signature line I had ITC's in both of the nodes they removed.  I am in Australia and they too classify it as node negative.  My surgeon believes the cells travelled in the bloodstream during surgery and also my Oncotype result was a 6 so both he and my Oncologist didn't believe it warranted any more lymph node removal or chemo.  I had a bilateral mastectomy and have been on tamoxifen for 2.5 years.  ITC's are quite contraversial as to the type of treatment they use but I am confident with the oncoptye result and hormone therapy.  Not sure why you had neoadjuvent chemo and I would definitely query why a full auxillary strip is necessary - if they are really concerned perhaps one or two more??  Hope all went well at your rendezvous.  Big hugs.

Carola32

Thank you Helena!

I'm still preparing for my appointment by being in a vile mood ;-)

They put me on neo-adjuvant chemo, otherwise my breast had to go, now we managed to save it all, and after my lumpectomy my breast even looks better than before :-D

Independant of my onco score, they wanted me on chemo because of my young age and to gain time, I was ok with that, even if the second part of treatment (Taxoterex4) worked so-so. I wanted my nipple to stay with me :-)

I will def discuss the possibility of taking a couple of more nodes. I certainly do not want a total dissection if I don't absolutely need one of course, I really hope they won't be like 'No, it's dissection or nothing'. Would seem so ancient... I have said no Tamoxifen (risks outweigh benefits for me - although some docs think I'm a complete loon - I do hope it's working out for you), but am scheduled for 8 weeks of radiation, I mean- It's supposed to kill the rest of remaining cancer cells, right? 

Congratulations on your low onco score :-D Must have been such a relief. As I've understood it papillary c. is quite rare. Hugs!

Amelie_Rose

Hi, just saw your post and wanted to say that I too had ITC in 4 of my sentinel nodes.  However, I was told that a full dissection wasn't necessary because ITC is still considered 'node negative'.  I am currently having adjuvant chemo, but it's because I am Her2+ and chemo is recommended for that type.  

Hope that helps.  Good luck.

Amelie 

Carola32

Hey,

Well the problem was that I'd already had chemo, they weren't sure if the chemo may had 'shot dead' some already formed clusters or not, if you get my meaning...So after much a do I'm now sitting on my couch since a couple of days with a drain from additional surgery last Wednesday. When my surgeon told me 'Do you really want to risk the very active ITC's jumping all the way down in your blood and maybe finding your liver to be a cozy place?' I decided. There were no less than 20 ITC's in the sentinel node, quite many...

Had a very hard time accepting my decision, but finally I feel very comfortable with a partial node dissection. I thought they were gonna take ALL of them, and I'll find out for sure in two weeks how everything went, but my surgeon said he would only take between 5-15 nodes, the gooey mass that drains your breast nothing else, 'We don't butcher women anymore' he said. Lucky me ;-O