sentinel node biopsy

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Mantra
Mantra Member Posts: 968
edited June 2014 in High Risk for Breast Cancer

I had a sentinel node biopsy when I had my left breast mastectomy. Three nodes. All negative.

I am 99% sure I want to have my right breast removed. If I have no signs of cancer, do they usually do the sentinel node biopsy at the same time? I would prefer not to have it done however, I know my surgeon said that once you have a mastectomy, you can no longer have a sentinel node biopsy.

I can't decide what to do. I don't want to have a SNB because of lymphedema concerns. However, I would hate to find out too late that my right breast really did have cancer and now they have no choice but to remove my nodes.

DH wondered if this scenario would be an option. He said is it possible to have the dye injection done the morning of surgery so they can map which is my sentinel node, but not remove the node (s). If my pathology comes back saying no cancer, then we do nothing. However, if it comes back saying they found cancer, then the go back in an remove the node (s) that they had previously mapped when I had my SNB. Does anyone know if this possible?

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  • mawhinney
    mawhinney Member Posts: 1,377
    edited October 2009

    I had never thought about this scenario but your DH's plan sounds feasible & reasonable. Talk to your surgeon.   Maybe some gals that have had preventive mastectomies can let us know if node biopsies were done.

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  • leaf
    leaf Member Posts: 8,188
    edited October 2009

    I've not had a mastectomy.  Maybe these are dumb questions.

    1)  Where would the surgeon know to inject the dye? (They normally inject it at the 'area of concern', right?)  What tissue should the surgeon remove to send to pathology?  How would you know it is possibly cancerous? Is there an 'area of concern'?

    2)  If there is an area of concern, 'traditional' pathology takes a few days to perform.  So if the pathology turned out to be cancer, you'd need a 2nd proceedure to do the mastectomy.  If you have them do a frozen section of your area of concern, this is (at least slightly) more inaccurate, as freezing can distort the tissue.

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  • kaeyreed
    kaeyreed Member Posts: 31
    edited October 2009

    I had a mastectomy on August 25, 2009 and they also did a SLN biopsy.  My diagnosis was DCIS but because it was high grade surgeon explained to me the risk of microinvasion.  This is why he did the SLN biopsy.  I was sure relieved when it came back clear.  Although lymphadema can be a side effect of this biopsy, the risk of having a lymph node with cancer was more than I could accept.  You have to choose which would be worse and which option is better for you.  I wish you all the best with whatever you decide and will pray that nothing is found. 

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