Worried about lymph nodes - failed sentinel biopsy

TechLady

I had a BMX on December 9 for DCIS.  The DCIS was in my left breast - it was a larger area of 5cm, multi focal, grade 2. At the time of surgery I was supposed to have a sentinel node biopsy (on the left) but evidently a bunch of nodes lit up and the surgeon didn't want to put me at risk for lymphedema given my diagnosis so he didn't remove or test any nodes.

I didn't even find this out until now when I requested copies of all my pathology reports and finally read them for myself.  They didn't find anything other than DCIS on the pathology reports - which is good since the sentinel biopsy didn't work.  But, I can't help feeling the "what if" something was missed?  I know it's likely silly but with the large area of multifocal DCIS on left, I still wonder...

Then I see on the MRI results done before my surgery there was mention of a 1.7cm mass in the left lobe of my liver that is "likely a cyst or hemangioma".  Again I realize it's highly likely it's all benign and MRI's are notorious for finding all sorts of extra things, but why did no one tell me before?  Between none of the lymph nodes being checked and this, I feel uneasy.  

I'm just wondering what others thoughts are the sentinel node biopsy or the liver thing?

MelissaDallas

hi Techlady. I can't help with the node biopsy, but I believe liver cysts, hemangiomas, areas of fatty infiltration and other benign findings are really common. I had areas on my liver that they determined are probably benign & a hemangioma on my spine when I had CT scans for ovarian cancer.

Beesie

The only reason that you have an SNB when you have a MX for DCIS is just in case some invasive cancer is found in the final pathology.  Since no invasive cancer was found in your MX pathology, there is no reason why you should be worried about the fact that you didn't have the SNB.  As it turns out, because you didn't have any invasive cancer, you didn't need to have the SNB.  So you luckily have avoided the risk of lymphedema and the need to take precautions to avoid the development of lymphedema.  I think that's a good thing and I applaud your surgeon for his on-the-spot decision. 

As for the MRI, I agree with Melissa. Liver cysts and hemangioma are common benign findings on MRIs. 

I can appreciate that when you put one and one together, you are getting worried.  But when it comes to these sorts of medical concerns, often one and one really are just one and one and don't add up to anything at all. 

 

Annette47

What Beesie said!  ((HUGS)) though - I understand why you would be worried, but I agree that there really is no need to.

mimi32

My surgeon opted not to do the SNB and I knew this before surgery. I trusted her explicitly and let her go with her gut instinct. She has given me the same explanation that Beesie described above. I completely understand, I too get those what if feelings but I have to let it go if I ever want to move past cancer.

TechLady

Thanks, everyone. The reassurance helps. Part of the anxiety has come because after my surgery my husband was told they did remove a node and it was clear.  But then when I read the actual surgical and pathology reports a few days ago, they did not say they removed nodes and there was no lymph node mention in the pathology reports. So there was much confusion.  I called and verified the reports with the surgeon who confirmed no node removal.

It's the unexpected things that throw me lately. I had mentally already checked off the list that the nodes had been tested and cleared so it was just a setback in my mind. I know it's not really a setback, but the confusion and what not has been unsettling.  

I do have one more question...since I've not had to have radiation or chemo (very lucky, I know), who oversees my care? I am seeing the plastic surgeon for reconstruction (obviously) but I kind of wish someone had been overseeing this whole process with me. I was told I didn't need to see an oncologist because no rads and chemo (makes sense). I'm fine with that and after talking with my BS the other day it sounds like he does follow up exams. I love my BS so that makes me happy but I'm curious if others have had the same experience with the whole "process"?

april485

Hi Techlady,

I am ER/PR+ so I am seeing a medical oncologist. If you are not taking any hormone blockers and your surgeon does not want to see you (I still see mine every 6 months...not sure why) and you did not have rads, I guess your OB/GYN would check you and you should also be vigilant in checking yourself. Because you had a mastectomy, I am thinking that your odds of recurrence are very low so hoping you can relax a bit now.