Micrometastitis in sentinel node

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Sukiann
Sukiann Member Posts: 310
edited June 2014 in IDC (Invasive Ductal Carcinoma)

My sentinel node showed  0.5 mm micrometastitis after the IHC stain (second stain that is more sensitive). Technically this is considered node positive although my surgeon and oncologist don't want to lump me in with the node positive group.  Has any one else had this?  If so, did it make a difference as to whether or not you had chemo?  It just makes me crazy that the cancer was "trying" to move into the nodes.  The sentinel node has been removed so the surgeon said that I am cancer free.  I have to wait for the oncotype test to come back to determine if I have chemo or not but this micro thing is just making me nuts!!

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  • barbe1958
    barbe1958 Member Posts: 19,757
    edited March 2009

    I get you! I had isolated tumour cells AND intramammary lymph nodes+ so I am going a bit crazy too. I worry that I may be undertreated and a bunch of ladies have PM'd me to tell me I am, but what can I do? I can't wrestle them to the floor...?

    I am getting an incision revision to remove excess breast tissue from my cancer side. I want it taken to pathology. I am VERY curious to see what it showed.

    I'm like you; the cancer TRIED to move on. How do I know some didn't slip by? Why did they even do a second stain?

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  • Sukiann
    Sukiann Member Posts: 310
    edited April 2009

    Thanks Barbeand hopefor30.  The waiting for the score is hard but I'm trying to put it out of my mind and just get on with life.  The only thing I hang on to is that the node is out so the cancer is "supposedly" out.  Your right Barbe, how do we know that some of those cells haven't slipped out.  We don't.  I guess everyone is in this boat since you could be really node negative and have a recurrence a few years down the road.  It's being in this gray area that is so troubling.  I don't have my oncotype score yet but I just know that I'll be in the grey area.  I'll let you know next week what it is.  Thanks again!

    Sukiann

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  • barbe1958
    barbe1958 Member Posts: 19,757
    edited April 2009

    I will also let you know if my pathology from the revision shows any cancer cells. Then I'll really freak out! 

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  • Sukiann
    Sukiann Member Posts: 310
    edited April 2009

    Hoping the best for you barbe!

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited April 2009

    Like you both, I thought the same thing about the cancer "trying" to move into the nodes.  I put a different spin on it and think more like the node(s) did their job and grabbed the cancer and isolated it from the rest of me.  Might help you get through this a little better Smile

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  • mom_of_2
    mom_of_2 Member Posts: 347
    edited April 2009

    My sentinel node was positive for metastatic carcinoma with largest focus begin 7 mm. 22 negative nodes were taken. I had SNB followed by neoadjuvant chemo no radiation. I fell into grey area due to age and microscopic involvement. Ultimately, oncology team decided to hold off on rads because I had such an aggressive course of chemo followed by bilateral. I hate being in the grey area!

    Good Luck Sukiann

    Nicky...GREAT outlook...do you mind if I use that? 

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  • Sukiann
    Sukiann Member Posts: 310
    edited April 2009

    I agree with Nicky!  Great way of thinking!  I'll have to adopt that too.  Mom_of_2, your 7mm was still considered microscopic?? Was it 0.7 or 7?  If it was 7 I guess that is why they considered you node positive. I think I am still considered node negative.  Will meet on wednesday with oncologist for oncotype results.  I hope the test is back from the lab.  I'd hate to go and find out that they didn't receive it yet!  Maybe I'll call.  Only 3 days to find out about chemo.  I don't know what it think anymore.  No chemo, Yeah! Then again, no chemo is that the right thing to do???   Mom_of_2, why was your chemo so agressive??  Is it your age or was it because of the Her2+?

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  • mom_of_2
    mom_of_2 Member Posts: 347
    edited April 2009

    7mm but surgical oncologist still referred to as mircoscopic...go figure.

    I was put into a clinical study of Abraxane/Heceptin/Navalbine. I was diagnosed at 40 with no family history. Right sided IDC and DCIS. ER+ PR+ HER2+ BRAC-. I had 20 consecutive weeks of chemo and Herceptin and now Herceptin and Tamoxifen. Opted for bilateral post chemo even though onc wanted to perform breast preservation lumpectomy. I believe it was personally the right decision for me. I didn't have oncotype testing because triple positive and needed chemo. It was awful but not the worst thing in the world. I had my last chemo infusion on election day and 5 months later I have 3 inches of very curly hair and more energy than pre-diagnosis.!I hope you don't need chemo but if you do...you will do fine and when its all said and done...you will forget the details...just like child birth!

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  • Britt
    Britt Member Posts: 731
    edited April 2009

    Hello - I also had a micrometic invasion in the sentinel node - 2mm - found out AFTER the lumpectomy/SNB procedure when I received the path report.  Opted for the ALND surgery where only nine nodes were taken out (all that were in the "pads") and all were negative.

    Had Oncotype test and results were 11 - 8% recurrence.  My medical onco strongly advised against chemo.  My Er & Pr are highly positive - 96% & 99% respectively - and am also HER2 negative.  So, just started the Round of Rads last Monday for 33 sessions, then when those are completed will go on Tamoxifen.

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  • Britt
    Britt Member Posts: 731
    edited April 2009

    Oh, I would also Iike to add there was no vascular invasion nor any multifocal issues.  During my initial surgery, the sentinel node and one other node were taken out - the second node was also negative.  2mm is considered a micromet.  My path report indicates it as N1mi.

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  • Jack55ok
    Jack55ok Member Posts: 37
    edited April 2009

    Hi,

    Yes mine was exactly the same. Microscopic cancer found in the sentinal node. I had my surgery and when they tested it then (while in surgery) it came back negative. After further tests it showed micrscopic traces. This meant I had to go back in for a 2nd surgery to remove more nodes to test, luckily it was only that first one and very little.But yes I had to have chemo as a result of those microscopic traces. I was not happy about the chemo but I am sure it was for the best. Good luck to you and God bless you!!.

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  • Britt
    Britt Member Posts: 731
    edited April 2009

    Jack55 -

    Did you get the Oncotype test?  Just curious . . . I notice your dx was over 2 years ago - don't know how popular the test was back then . . . and what course of chemo were you on?

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  • SoCalLisa
    SoCalLisa Member Posts: 13,961
    edited April 2009

    I had about the same thing before they had ONCO testing...I had two opinions and

    they both agreed chemo...I had CMF

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  • Jack55ok
    Jack55ok Member Posts: 37
    edited April 2009

    Hi Britt,

    No I did not have the Oncotype. My chemo treatments consisted of 5 treatments of Cytoxin and Taxotere. It's funny my DX was 2 years ago and I feel like it was yesterday! We go thru so much with the long journey!   I had my first clean mammogram this past August, I thank Jesus!

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  • Britt
    Britt Member Posts: 731
    edited April 2009

    CT x 5 - every three weeks?  Did you also get rads?  Any bad reactions to the Taxotere?

    I know - the time goes by SO fast and I feel so incredibly fortunate that they do have the Oncotype test . . . . I know there is some controversy about its accuracy, but I am willing to take a chance - my faith in God gives me the strength to take that chance . . . my med onco was adamant that I did not need chemo. Also got a second opinion shortly afterwards and received the same answer.  So, onwards to Radsland I go - and it's time to leave for my appt - and God bless you for the clean mammogram and may it continue!!!!

    Maria

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  • Jack55ok
    Jack55ok Member Posts: 37
    edited April 2009

    Maria,

    I did get sick from the chemo. Mine always started about 3 days after treatment and went for about 7 days. It was 3 days of just plain sick then another 3-4 days of stomach intestinal type sickness. It was spaced out every 3 weeks, it felt like I was just getting better only to have to go back in for another. After chemo I had 36 radiation treatments.

    It could have been worse, I have heard where people get so sick they can not keep anything down. Mine was not that bad.

    Your faith in God is EVERYTHING! May he bless you thru your journey. I will be thinking of you!

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited April 2009

    Yeah!  Amen to what Jack55ok said!

    Sessna1

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited April 2009

     See Inside This Book

    See Inside This Book

    "Laughter is an Instant Vacation"

    Please click on the Words "See Inside This Book."  I couldn't narrow down the link any better.  Thank you.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited April 2009

    Sorry about that.  I like the "Laughter is an Instant Vacation" book.  It could have started with the dog picture on the cover.

    http://store.simpletruths.com/shared/StoreFront/default.asp?CS=simplet&StoreType=BtoC&Count1=796886622&Count2=714027047&CategoryID=146&Target=products.asp

    I couldn't get a better hyperlink to come across.

    Love in Christ,

    Sessna1

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  • Sukiann
    Sukiann Member Posts: 310
    edited April 2009

    I just got back from the oncologist.  The oncotype test was never sent!!!!  My oncologist was furious about it because he clearly ordered it.  Anyway, after he found out that the micromets was up to 0.5 - he went to see the pathologist and looked at the slides, he said he wanted to treat me with chemo.  I will have 4 rounds of T & C three weeks apart.  I almost am relieved  because I didn't want to have to make the decision.  I was agonizing about it.  They did send out for the oncotype test (for real this time) and I will have results in two weeks but he said regardless, he wants me to do chemo.  He felt that the micromets demostrated the behavior of the tumor and he said that the chemo would be necessary.  If I were his sister, mother, or wife he would say the same.  So, I go for "chemo training" next week, then on to Disney World the next week, then onto chemo the following week (and the day after my first infusion I am taking my Dad into Mass General to see a specialist for Alzheimers - the doc said I should feel ok the next day to go???).  Alzheimers, just another one of life's special "gifts" to the human race.

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  • comingtoterms
    comingtoterms Member Posts: 421
    edited April 2009

    Being in a gray area is a very scary place to be.  When I finally just asked my Oncologist point blank what he thought I should do, he said he recommended chemo.  It seems that the common medical practice now is to place much decision making in the hands of the patient, but for many of us, it is a tremendous weight that we don't necessarily feel comfortable carrying.    I had two additional lesions no one was aware of that were found  after my MS and one lumph node with focal sucapsular isolated tumor cells.  I know that makes me node negative, but they also had to take 25 other swollen nodes out as a precaution!!!  For me, I haven't had a "warm and fuzzy feeling" about tests - my mammogram was clean two months before I found two palpable lumps and the radiologist performing my core biopsy told me I had nothing to worry about as he was grinding the tissue out of my breast!!!  Because of this, I need to know that I have done everything in my power, right here, right now, to get rid of whatever might be floating around in there that I don't know about.  I start 4 bi-weekly rounds of AC and then four bi-wekly rounds of T next week.We all have to do what is right for us.

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