Lymph node involvement

Cherry02031978

Hi everyone!

I have clinical stage 2 IDC, 2cm, grade 3 breast cancer at the 2:00 position,. Er/pr positive, her2 negative. Next week I will be having a lumpectomy, and sentinel node dissection. So far from ultrasound, and MRI nodes look ok. However, has anyone had their nodes to look ok and then after surgery be positive with cancer? Scared to death to start the journey but I just want it out of my body. I'm 37, no Gene mutations, or family history

keepthefaith

Cherry, Sorry you found yourself here. I hope you will find this forum to be very supportive. I have no answer to your question, but once you have your SNB, they will be able to tell you if you have node involvement. If you do, try not to freak out. There are many here that have had node involvement and gone on to live happy, long and" healthy" lives. I remember feeling the same way when I was diagnosed....just get this (*^&^$##*&&*( thing out of me!!! When is your LX? You will have a lot of decisions to make as you go through treatment, so don't be afraid to ask your medical team questions, get second opinions if you need to and BREATHE!!! You will start to feel better and more "in control" once you start your treatment. Wishing you the best. ((HUGS))

readytorock

My 9mm cancer in my lymph node did not show on US or MRI. Surgeon actually told me after surgery that my lymph nodes looked healthy. Was quite shocked when results came back as nobody had really thought that it was a possibility that it had spread to lymph nodes and would need chemo.

Anonymous

Hi Cherry02031978. I was in a similar situation. MRI and Ultrasound didn't show any lymph node involvement. But my surgeon had my nodes tested while I was in surgery so he would know how many to remove. Only one was positive out of 22 nodes removed. It was 4mm of cancer, so very small. But I still went ahead and did the oncotype (15) and I decided that it was best for me to only do hormonal therapy. I do have family history of breast cancer but no gene mutation (for me, my siblings otherwise...). But that is a long story. A positive lymph node doesn't necessarily = chemo anymore. The makeup of the cancer is more important. Now, if I had more than one node positive or a mid-range oncotype or grade 3 cancer, I would have probably done chemo.

This is a scary time because there is so much uncertainty, but when you're scared, don't go to google. Come here and talk to the women and men who have gone through what you're going through, and they're doing okay! Best wishes on your surgery and have faith you're going to do just great!

LizM

Cherry, Before my surgery my surgeon thought my cancer was 1.5 and no lymph node involvement. Radiologist did an ultrasound of lymph nodes. After surgery my cancer was 2.1 cm and 1 pos lymph node with 8mm. I was devastated at the time but here I am 11 years later and doing fine. Hopefully you won't have a positive lymph node, but please remember that if you do, your chances for long term survival are still good - you just might need a little more treatment.

labelle

My breast MRI missed my positive node (2mm). It also showed my tumor to be 1.5 cm but it was only 7mm when excised.

Imaging gives doctors a good idea of what to expect, but it is far from perfect. Due to a low Oncotype score and limited node involvement, my treatment was rads and hormonal therapy-no chemo.

Hope your surgery goes well with no nasty surprises and you have a speedy and uneventful recovery.

Runner70

nobody thought I would have positive nodes. My cancer was only 1.2cm and not even palpable. On gross exam all my nodes looked benign so I planned on radiation and tamoxifen. Then 3 days after my surgery I got the bad news that one of my nodes was 12mm full of cancer. My life changed that day more than I ever imagined it would. Sometimes I still can't believe it.

It's hard to be patient with all the uncertainties and not knowing the plan. And try not to freak out about the responses you're getting. The only ones responding are the ones who got bad news.

Lolis197138

Hi Cherry,

Imagining helps the doctors get an idea of the situation, until the surgery and pathology report comes back, there is no certainty. I went into the surgery with the idea that 2 of my lymph nodes were affected and after the surgery,i was told 8 of them were affected with 5 of them having macro mets and only 1-2 showed on the imagining tests.

I hope you have no involved nodes!

Wishing you all the best.

Lolis

Coupon

That's me. Before mastectomy, MRI & ultrasound didn't detect any node involvement. SNL biopsy performed which concluded 1 node involved. Disappointed and pulling my hair to decide whether chemo or not. If so, which regime.

Best of luck to you!

jojo9999

FYI: when your nodes are clear from imaging - mamo, us, and mri, you are declared "clinically node negative", but I don't think they can declare you "node negative" until after the SNL. Prior to SNL, I was clinically node negative, but they found a 2mm positive node.

Nancy2581

Unfortunately yes. I had 3 doctors telling me they did not think the cancer had spread to my nodes. Wrong. I had a 2.8 mm mass in one of three. At least there wasn't anymore. Hang in there.

Nancy

Sabina1974

Hi

YES HAD CLINICALLY NODE NEGATIVE, BUT UNFORTUNATELY WHEN THEY WERE SENT TO PATHOLOGY CAME BACK AS TWO POSITIVE NODES. THEY CALL IT MICROMETS AS COULD NOT BE SEEN ON IMAGING. BEST OF LUCK WITH YOUR TREATMENT, I AM STARTING CHEMO IN THE MORNING.

Hopeful82014

Sabina, good luck with your chemo. I hope it is much easier on you than previously. Take care.

Sabina1974

Hi Hopeful

So far so good, absolutely no sickness just feel very tired but I can cope with that. I hope you are doing well yourself!!

Sabina

Hopeful82014

I'm glad to hear that, Sabina, and hope you can get through the fatigue in fairly short order. I don't know what regimen you're doing but if it's TCx4, you're one quarter of the way through. Hang in there, and cut yourself as much slack as you possibly can.

Sabina1974

Hi Hopeful

Yes TC chemo for 6 cycles as I had 2mm in sentinel node. Grade 2, 1.6 cm and hormone fed so hoping it will stay away!

Sabina

Cherry02031978

Great news!!! I had my lumpectomy last Tuesday. All margins came back clear and my sentinel node that was dissected cane bank clear!! So happy!!! Because I'm 37, and my tumor was 2.2 cm I'm sure I won't get out of chemo. I'll find out more this Friday. Sabrina what kind of chemo are you doing

Sabina1974

HI Cherry

I am doing TC, which at the moment so far so good!

sabina

Hopeful82014

I'm glad it's going well, Sabina. Cherry, that's good news about your pathology. I hope you're recovering well.

stephilosphy00

I was diagnosed with IDC last Wednesday. One axillary lymph node (the lowest one in armpit) looked a little thicker during ultrasound guided biopsy so the doctor also biopsied that lymph node. The result came back positive .

Here is the lymph node biopsy result -

1. Tumor is not surrounded by lymph node cortex. Clinical correlation
necessary to determine location of lesion.

2. The core biopsied lesion represented an axillary lymph node with
thickened cortex and echogenic hilum.

Does it mean I might only have one lymph node affected since other lymph nodes look normal under ultrasound?

Thanks

Faye

Hopeful82014

Faye, unfortunately, no it really doesn't mean much. You may have micro-metastases and/or isolated tumor cells in other nodes that wouldn't show up on US. You could also have a node that looks o.k. but has 2mm or more of cancer.

I know, from personal experience, how deeply unsettling (and frightening) it was to know from the outset that you have one or more positive nodes. I think it's important to try to stay on an even keel; don't get your hopes up too much nor be too pessimistic, either. If you do have additional nodal involvement found at surgery and had convinced yourself that wouldn't be the case, it can be pretty devastating. It's very difficult, but if you can somehow tell yourself that you just won't know until surgery and it is what it is, you'll probably save yourself some pain.

I hope you'll get good news, eventually, and that one node will be the full extent of it. In the meantime, take good care of yourself, take some deep breaths, and hang in there. I'm so sorry you're in this position. Please come here whenever you need some support, etc.

stephilosphy00

I will start neoadjuvant chemo soon anyway. Hopefully it will help me clear the nodes before surgery.

Hopeful82014

Faye, I truly hope it does. Good luck with it.

stephilosphy00

PET scan came back clear !

CCtoo

Hi keep the faith....why did you need chemo when no more involvement? I have just heard from lumpectomy with 1of 3 node+. They said no chemo!! Only radiation, which I don't think I can handle....I am 80 and already tired!!

Nick60F

Hi all, just thought I'd jump in here with some information that some might find useful. My wife was diagnosed in October. She had two small tumours and her nodes looked healthy on ultrasound so we were all cautiously optimistic that she'd have clear nodes when they did the SNB. Unfortunately that wasn't the case - they removed one sentinel node and it had 2.5mm of cancer. We were pretty upset by this and the reactions when we told people were not helpful - they offered us pitiful looks and doom and gloom body language. It seems to be written in BC folklore that clear nodes = great, node involvement = disaster. In terms of prognosis, it feels like falling off a cliff. That's what I thought myself to be honest, and in the past I have been as guilty as the next man in asking "what about the lymph nodes" as my opening question when learning of someone I know being diagnosed with BC. Having recently done a lot of reading, and after talking with my wife's oncologist, I now have a different view of the world. For sure it's preferable to have no node involvement, but if you're not in that happy position you might want to check out an online stats tool that UK oncologists use. If you haven't heard of it, it's called NHS Predict. Just Google that term and choose version 2.0 of the tool. This is a fully validated calculator in daily use by UK oncs. I went through it all with our oncologist in his office, on his computer. Set up your pathology and other information and you will get your stats. I used it to assess the implications of varying degrees of node involvement. It confirms what I said above - having a positive node or two is not a disaster. I thought it might bring comfort to some :-)

cive

CCtoo:  It is because of your age!  The older you are when you get it, the least aggressive breast cancer is.  Rads really aren't that difficult other than the time it takes to got  get radiation every day.

Sabina1974

Hi Nick

That is so true when my nodes came back the breast cancer nurse and the surgeon had faces on them like someone was dying. All I was told was "we want node negative ". And sure when it came back like your wife's 2.5 mm thought my whole world had ended, it's not until you get into the chemo centre that you realise a lot of people have positive sentinel nodes. Hope your wife's treatment is going well we have no 4 on Friday.

Saving

Fearless59

Hi, everyone,

Original diagnosis was DCIS and lots and lots of it.... mastectomy pathology report showed, in addition to the DCIS, 1 mm invasive cancer in the breast and of the 4 sentinal nodes removed for testing, 1 was positive with the invasive cancer, 5mm. I cannot figure out how the lymph node cancer would be bigger unless the cancer started somewhere else in the body? Or maybe the piece in the breast could not grow at a normal rate due to the ER-PR postive DCIS around it, eating up all of the estrogen?

As a safeguard in case untested lymph nodes may be also involved, Radiation docs think I need that and an Oncologist thinks I should do chemo in case cancer travelled further. This is one of my most difficult decisions. Hate to do overkill but do not want to be foolish and be unnecessarily zapped with either of these. I am one of those people who does not even want to take an aspirin because I so much value my mental clarity. Any thoughts? Thanks

Fearless

Fearless59

Oh, one more thing......

My optimism is what got me in trouble in the first place. I did not get a mammogram for 17 years.....

I want to think my body --- should --- be able to handle cancer but that optimistic attitude is what got me where I am, down to one breast. Maybe both chem and rad is the way to go. It is just a big decision. The internet is full of horror stories about both. One relatives gave me "natural cures" books, as if all the doctors know nothing, and I tend to think that natural cures are great. But I would feel pretty stupid if I risked my life testing this and lost. My family would have a very hard time. Ugh.

Hopeful82014

Fearless, have you had Oncotype DX done on your tumor? It can give you a better idea of how much you might benefit from chemo. Some people will tell you it can't be used on node positive cases, which is NOT correct. In your situation it might be extremely helpful.

Also, if you wish to make your profile public that can help us to help you, without asking you for details of your diagnosis again and again.

And yes, don't you just love how your friends and/or relatives believe they have some magic info that your treatment team has never run across??