Having a Bi-MX and Sentinel node biopsy in 2 weeks

trishann

Hello everyone.  After many days of reading this forum I've decided to reach out.  First of all this has been a great source of information and support because of the positive vibes and strength I get from people going through similar circustances - thank you for that.

What I'm reading and understanding (I think) is many Breast surgeons will to the sentinel node biopsy when doing a Bi-MX because there will not be a good time to go back in to do the procedure.  So what I'm understanding is, it is more of a matter of "opportunity" versus "need" .  I had a core biopsy on my left side with DCIS II - III grade.  Then 2 areas were biopsied on my right side during MRI as nothing showed on mamogram on this side.  Path for those 2 areas said grade II.  Neither showed microinvasion and were cribform, papilary, and solid.  No tumors felt anywhere as the left side only showed small area of microcalcifications. 

So at this stage I'm fearing the final path report more than the surgery - but feel I could possibly have some optimism with all 3 biopsies showing no microinvasion.  I just fear a 3rd call from the BS about having more to deal with.  I know that sounds so selfish as so many women are going through so much worse - I just would like to maybe put this nightmare behind me.  

Any comments about having the sentinel node biopsy and the final path that might be encouraging would be great!  I am having reconstruction right after the MX.  Love and blessings to you all and thank you!

Ariom

Hi Trishann,

Glad you felt comfortable enough to reach out. There are many here that will come to answer your questions.

We understand exactly what it is like at the beginning and how overwhelming it all is, but it does get better. We all feel this fear of the unknown.

I had a Umx in December and had the Sentinel Node Biopsy done at the same time.

My surgeon explained to me that if I had chosen to have the lumpectomy and radiation he wouldn't have done a SNB. He then explained that it would be remiss of him not to do it if I decided on the Mx because it would be right there when he performed the surgery. He also said that if there was any change to the initial Pathology after the surgery it is more of a problem to have to go back in to perform the SNB after the Mx.

That sounded perfectly logical to me, and avoidance of any more surgery sounded good to me. I was very fortunate, my Dx of Pure DCIS was correct and my Node was clear.

I am nearly 8 weeks post op and I am doing just fine.

I wish you all the very best!

Come here often and let us know how you are doing.

trishann

Hi Arion,

Thank you for your message!  I'm SO glad your nodes were clear and you are doing well :-). 

I'm also wondering if it is in my node, will they just do the MX and hold off on reconstruction and possibly remove more nodes?  I'm sure the BS went over this but it was all a little fuzzy and the more I read the more questions I have.  I also have a fear that my 3 core needle biopsies might cause a problem with the pathology report - I've heard of "seeding" and microinvasion from the biopsy, etc.  I just hope the path will be a true result and that the biopsies haven't added complication to getting an accurate path report. 

Much love, prayer, and thanks :-)

Ariom

Hi again Trishann,

I am so sorry that you are feeling this way, I can feel your fear.

I can't say for sure what the procedure will be for you, but if, as you say there is just DCIS there you have a Dx the same as I did.

Is there any way you can meet with your surgeon again, perhaps take someone with you to be another set of ears. I know when I went to mine for the first time I just heard Blah, Blah, Blah. Luckily my husband was there, he heard more than me.

Yes, I guess the SNB is being done as "Opportunity versus Need". I personally didn't want to have to have my incision opened again if my Pathology came back with any little surprises. Not that the Surgeon was expecting to find anything else.

Try not to dwell too much on worrying about there being any problem from the biopsy. I read up on that too after my Core biopsy, but there was no clear connection of biopsies causing microinvasion, or seeding.

It is very easy to get caught up in all the negative scary stuff. The reality is that once you know what is going on, and things start to settle down, you feel you can breathe again.

Try to be kind to yourself, you'll get through this awful time, and there are lots of us here to help you when you need it.

Take care!

Annette47

The reason they do a Sentinel Node biopsy when someone is having a mastectomy, even if no invasion is suspected is that once they've done the mastectomy and the breast is gone it is impossible to identify the sentinel nodes (which is done by injecting dye into the breast near the tumor), so if there is any invasion found on final pathology, the only option is to do a full axillary node dissection, which is a much more serious operation with much higher chance of permanent side effects such as lymphedema.  

In my case, they knew from the initial core biopsy that there was an invasive component, which is why it was done at the time of my lumpectomy, but if they have no reason to suspect invasion, then with a lumpectomy they could always go back and do it later if the final pathology shows something as the breast is still intact so they can inject the tracer dye.

trishann

Thank you Annette47 for that explaination.  That does make sense.  I appreciate that!  And I'm glad you are doing well and on your way to total recovery.  I do have one additional concern.  My original mamo was 11/30 2012 and I waited until Jan. for the biopsy for insurance reasons.  Which turned into another biopsy on the other side.  So now my surgery is March 1 and 3 months will have passed since mamo.  I just hope I haven't waited too long!!  But I understand there is really no way to tell how long the DCIS has been there.  My mamo showed small cluster on calcs on one side and nothing detected on the other until mri.  So I'm hoping that still means an early catch.  Thanks again.

LAstar

I had two nodes taken that were both clear because my cancer was pure DCIS.  I have since had some early signs of lymphedema, which I am dealing with using massage and a LE sleeve.  I was told that I had about a 3% chance of LE since only 2 nodes were taken.  I made the mistake of accidentally letting someone take blood from that arm then had a mole biopsied on my back that was close to that shoulder. I felt like an idiot for forgetting!  That arm has to be protected for the rest of your life from blood draws, injuries, bug bites, sunburn, etc. to be sure that you don't get LE.  It's a hassle!  Given the risk of LE, it would make sense to me to use the dye during the MX to identify the sentinel nodes then leave a titanium clip (like the ones from our biopsies) in that location in case the lymph nodes were found to be involved.  Then the lymphatic system doesn't have to be disrupted unnecessarily.  Thoughts?  It is not that easy?  The lymphatic system is so complicated!