Sentinel lymph node biopsy- 8 lymph nodes removed

Redcanoe

Hi everyone, I had a lumpectomy today and when I woke up, the surgeon told me not to be alarmed at the number but he took 7 or 8 lymph nodes that came out basically in two pieces. He said they didn't look outwardly suspicious and this can happen. I had an MRI last week and all nodes looked clear except one kinda off looking one, which was biopsied by core needle and came back negative. He said that is the only one that looked different today during surgery. Sounds like it could still come back positive despite 4 ultrasound guided samples.

Has this happened to anyone else?

AliceBastable

Sometimes they can't control how many nodes come out if they're in a cluster. I just had one out but it had a micromet, which surprised my surgeon. It's why nothing is definite until the post-op pathology report is back. Little things don't necessarily show up on pre-op imaging.

NorCalS

My MRI before surgery was clear and we were hoping for a PCR. Well, they did a sentinel node biopsy before the lumpectomy and one node turned out positive, so they performed an axillary dissection. A total of 9 nodes were taken out, one positive, and a few had isolated tumor cells which they consider negative node. We were all surprised that there were remaining cancer cells in the tumor bed and a positive node. So, echoing AliceB, you just don’t know until the pathology report.

LivinLife

Redcanoe... I have not had that experience. just saw you posted and am so glad you've been able to finally have your surgery. You've gone through a lot up until now. Please let us know when you hear about final path... I know you will... Just so good hearing from you!

Beesie

The thing with doing a needle biopsy on a lymph node is that if there is only a small area of cancer, the needle might miss it. This is why sentinel node biopsies, which remove the entire node(s), are always done during surgery when someone has been diagnosed with invasive breast cancer, even if a previous core needle biopsy of the node was negative. So yes, it is certainly possible to have a positive node despite having had a negative needle biopsy.

That said, the natural behaviour of nodes is to react when presented with infection or germs, so it could be that your breast biopsy caused your node to react (hence the appearance on the MRI) and the needle biopsy on the node itself might have inflamed it more. From reading posts on this board, this is not that unusual - having nodes that appear enlarged after a biopsy either on imaging or from appearance during surgery, but end up being negative when checked out under the microscope. So it's still very possible that you could be node negative.

Do you have an appointment set up to review your pathology report with the surgeon?

AmusingSoprano

@Beesie I had an SNM with my DCIS, purely because of the biopsy pathology - my surgeon was concerned that there would be invasive found after the lumpectomy. But I understand doing this is very uncommon.

Redcanoe

I got the results of my sentinel lymph node biopsy. Apparantly he took out 5 lymph nodes, not 8. Two came back positive - one was 10 mm and the other 14 mm. The other three lymph nodes were clear. My surgeon said that I am a good candidate to skip the full axillary node dissection because the risk is greater than the benefit. There was also lymphovascular invasion but no extracapsular extension. I am so freaked out right now.

LivinLife

I can definitely understand increased emotion - anxiety and fear - with the news you received. At the same time I think you will hear from others who had positive nodes and treatment has been helpful. This is not something I experienced (positive node) or know much about. I saw your post and want to reach out with support and validation!!! I know you live in a remote area and traveled quite a ways for testing and surgery... I hope you will be able to access good treatment with providers you trust and are comfortable with - without too much difficulty... that adds to challenges and emotion I'm sure....