If not in lymphnodes does that mean not spread?

Monkeybroth

Good Afternoo

could anyone tell me please, if on diagnosis , there is no cancer showing in the lymph node biopsy, does that mean the cancer has not spread (even though there are 3 tumours in breast?)

Many Thanks

ElaineTherese

Hi!

No, that does mean that your cancer has not spread, nor does it mean that you don't have cancer cells circulating in your bloodstream and/or lymph system. However, it may be less likely that your cancer has spread because cancer does often surface in the lymph nodes first. Hence, having clear nodes is a good thing!

In the end, though, you will only be sure of having clear nodes after your surgery. The surgical pathology report always trumps biopsies.

Hope that you do, in fact, have clear nodes!

Monkeybroth

hi elainethere.

Thanks for the reply. Its actually for my sister. She had biopsies last week and is going for treatment plan tomorrow.

Her lymph node biopsy with needle came back clear so I thought she might be out of the woods where that was concerned,

So when they do the surgery , will they take some lymph gland or something please? And how will they check to make sure its not travelling?

Thanks v much...i am in the dark about all this as you may be able to tell,and i want to help her as much or as little as she wishes, but right now we are both in the dark.

Xxxx

Salamandra

Monkeybroth,

Did your sister have the sentinel lymph node biopsy already? Most of us have it at the same time as the mastectomy/lumpectomy, so I think that is what ElaineTherese is referring to. But it is possible for it to be done separately.

If they've already done the lymph node biopsy and didn't find anything, it's likely they'll stop with the nodes. It's possible and sometimes happens that the sentinel nodes will be clear but there is cancer in deeper nodes, but it's rare enough that the sentinel node biopsy is considered reliable.

As ElaineTherese said, clear nodes does not guarantee it hasn't spread, but it is a good sign. There are no tests currently sensitive enough to be able to pick up cancer in the blood stream or hiding out in the body. That's why anyone who's had an invasive cancer (as opposed to in situ) is treated as though it's possible that cells have escaped. That can mean chemo and/or long term endocrine therapy.

Lots of women with positive nodes do fine and never metastasize. Women with no positive nodes continue to have risks of metastasis nevertheless. It's favorable for prognosis, but no guarantee.

exbrnxgrl

Sorry to hear that your sister is going through this. Unfortunately, bc can spread via the bloodstream, so clear lymph nodes are a good thing but not a guarantee. You don’t mention what type of surgery she is having, so it’s hard to speculate on whether they will take any nodes at the time of surgery. A quick call to the doctor should yield an answer to that question.

Bear in mind that bc cells can float along through the body undetected until such time as they have grown big enough to detect or cause symptoms. Oncologists monitor things differently based on the individual, their own philosophy, current guidelines and research. There is no single path, which is frustrating but true. For instance, some oncologists do tumour marker tests. My onc does not as she believes they may not be accurate and would be followed by a PET scan if markers are rising. My onc simply does regular PET scans but will do additional ones if I have symptoms.

There is a lot to learn, and be overwhelmed by, about bc. Try to learn about what you know, based on test results, imaging, pathology reports but don’t spend too much time on the “what ifs” . Best of luck to your sister

Monkeybroth

hi everyone!

Thanks so much for the replies.

My sister gets her treatment plan tomorrow. Last week they did the breast biopsies and the under the arm lymphs..which were clear.

They said the options will probably be a lumpectomy or full mascectomy...but they will tell her this tomorrow.

Does the fact that she has two tumours (if thats the right terminology) with possibly one more under the nipple, which they couldnt get to, mean anything significant at all?

And her breast was dimpled, rather than protruding with a lump...does that mean anything?

Just trying to prepare

Xxx

vlnrph

I had two tumors, in separate quadrants, which meant mastectomy since I was only a small B cup. If they can get both, plus the nipple area without taking a great amount of breast tissue, a lumpectomy might work. There are reconstructive techniques like fat grafting that fill in the dents or a reduction could be done on the contralateral side in order to attain symmetry.

Unless the lump was very large and just under the skin, I don't think a protrusion would normally be seen. Since one of my lesions was lobular, it was not palpable. The other was so small, it could not be felt and was only found on the MRI done to more fully assess the size of the ILC.

The thing about having different pathologies is that an inherited mutation may be present. Should this be the case for your sister, a referral for genetic counseling would be a good idea and help tip the balance toward which surgery she selects. Also, a needle biopsy of a lymph node could miss micromets on the surface...

Monkeybroth

Thanks Virnph for the good explanation, much appreciated. Forewarned is forearmed and all that.

Xxx

Meow13

I had 2 tumors ilc and idc and a suspicious area. They recommended a mastectomy I did that and the pathology said cancer was confined to 2 separate tumors. I did the sentinel node biopsy at same time as the mastectomy it was clear. Chemo was recommended for me but instead I did 4 years AI drugs (hormone therapy, to clean up stray cells).

I also had DIEP reconstruction all my own tissue no implant, looks great. I am on my 8th year of no cancer.

Monkeybroth

Thanks Meow. Pleased it worked well for you. Xxx