Sentinal node biopsy...yes or no?

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Hehewuti
Hehewuti Member Posts: 9
edited June 2014 in IDC (Invasive Ductal Carcinoma)

Thanks to everyone for all of the helpful knowledge the last month or so. Now, I have a question. After a needle biopsy it was determined I had DCIS and needed a lumpectomy. The lumpectomy turned up about 8mm of IDC along with the DCIS. The surgeon did not do a sentinal node biopsy during the lumpectomy. I saw the oncologist last week to discuss radiation. He sent me back to the surgeon to discuss doing a sentinal node biopsy. The surgeon said he thinks since the IDC is so small nodes should be OK, but, that he's on the fence, and that it's up to me. Altho, another surgery "sucks", and I wish he had checked the nodes before, it seems they should be checked. Does this seem correct? Or, do I not need the nodes checked? If it matters, the margin around invasive d.c. was 6mm and DCIS was 3mm. Thanks

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  • ruthbru
    ruthbru Member Posts: 57,235
    edited April 2010

    I, myself, would want to know FOR SURE that everything was OK & would have the biopsy done. I would think that your oncologist would want that too. I thought it was a standard thing that a person wouldn't even have a choice about. Anyone else with any information that says anything else?  Ruth 

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  • koshka1
    koshka1 Member Posts: 678
    edited April 2010

    Hi there....

    I had a 4mm and a 1mm IDC mixed in with my DCIS.  I was told with a tumor that small it was about a 10% chance that it could be in my lymph nodes.  I went ahead and had the sentinel node biopsy.

    You don't want to take the chance if one of those darn cells started to travel outside your breast.

    If they do it right,,,they will only sample 2-3 nodes and you will heal without much intereference.  I was doing yoga within the month.

    Hugs and keep me posted.

    Kosh

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  • suekb
    suekb Member Posts: 22
    edited April 2010

    Lymph node involvement is a big deal so it would be difficult to not worry if you chose not to do it. If you have any family history then I definetly would do the SNB. I had DCIS but since I am BRCA 1+, I had both side checked. I would have the SNB if I were in your shoes. I have a feeling this surgery alone would be out patient. Good luck and feel free to ask questions. I had mine with a bilat on 3/17.   

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  • M360
    M360 Member Posts: 356
    edited April 2010

    I was told the same as you.  They assured me no lymph glands were involved.  I had the SNB and had cancer in them.  Then I had to have an auxiliary lymph dissection, there was cancer in some of those too.  I would go through with the SNB, doctors don't know until they take a lymph gland out and get a pathology report if they have been affected.  Like suekb said, lymph node involvement is a big deal.  I pray that all yours are cancer free.

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  • Hehewuti
    Hehewuti Member Posts: 9
    edited April 2010

    Thanks so much for the advise and encouragment to make the choice that I needed to make. That helped me sleep last night! Today I scheduled the sentinal node biopsy for next week. Best Wishes, Prayers, Hugs, & Good Health, back at you!     Wendy

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  • LauraM
    LauraM Member Posts: 251
    edited April 2010

    Hehewuti - I am glad that you did that.   I had the same IDC as you, 8mm in the middle of my DCIS.  My surgeon had to go back in and do the Sentinel Nodes surgery also and luckily for me she took a tail area of fatty tissue around the Sentinel Nodes out along with the nodes.  My Sentinel Nodes came back negative but in that fatty tissue they took out around the two nodes, they found to micro tumors, both under 3 mm.    This made them go back in and take out the rest of my axillary nodes.  I only had 14 and cancer was in 3 of them, the docs were very surprised.   This was not meant to scare you, just to let you know how important is was for me to have my sentinel nodes removed and also to have a doctor that went the extra mile and took out the fatty tissue to have that examined also.  I have heard from my other doctors, plastic surgeon and Oncologist that not many surgeons take out the fatty tissue area and have it tested so it might be something you could ask your surgeon.   Prayers are coming your way from me.  Good luck.

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  • Lorraine5
    Lorraine5 Member Posts: 35
    edited April 2010

    Hi, I just was confirmed with DC, moderate grade. I discussed with my surgeon the options.  I work in a pathology department and we do quite a number of sentinel node biopsies.  Even if the margins are clear on your lumpectomy, I personally would opt for the node biopsy.  This is minimally invasive and does not have the side effects of axillary dissection and biopsy.  Just in doing that you will have better piece of mind.  I am more likely than not going for a sentinel node biopsy with lumpectomy myself.  The docs do not think this is invasive and MRI showed a well-circumscribed lump (thankfully).  But I don't want to fool around with this nasty dx, so will opt for the extra.  If they come back positive to any extend, then you can decide on what further course of action to take.  I'm not looking forward to any of this, but I fully plan on not only surviving this - but conquering this @$#@$ thing.  Good luck with your decision and follow what your heart says.

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  • Susie123
    Susie123 Member Posts: 804
    edited April 2010

    I'm glad that you decided to have the SNB. So much of your treatment will be determined by the outcome. I wish you the best!

    Susie

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  • LINDAGARSIDE
    LINDAGARSIDE Member Posts: 345
    edited April 2010

    Hi there.  I for sure would opt to go right back in there and have your SN's done, without question.  The risk is too high not to.  This particular game is NOT a good game to gamble on no matter what any doctor tells you about the odds.  The oncologist and breast surgeon may think one thing...but if it was their wives...I bet they would have her in like a flash.

    It has already been noted that the SN is no biggie to recover from.  I can vouch for that.  I'm 58 years old and not in great shape but was packing wood up the stairs within 5 days of the surgery.  I've never had any swelling etc.  It's all good.

    Ultimately, it is your call of course...but as I said...why take the gamble?  You've got everything to gain and as well, possibly everything to lose.  Good luck with your decision.

    OOPS...I see you already made the decision to go ahead with it.  OK...I won't delete this because it took me too long to type.  LOL.  Here's my 25 cents worth. 

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  • Patriotgirl
    Patriotgirl Member Posts: 26
    edited May 2010

    I had a similiar situation.  My surgeon did the SLNB, but prefaced the surgery with "I'd be SHOCKED if you had cancer in the lymph nodes."  Well, she removed 8 and I had small amounts of cancer in 2 of them.  This will completely change my treatment approach so I guess it really was "worth" it.  By now you have probably already taken action.

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  • Seabee
    Seabee Member Posts: 557
    edited May 2010

    Yes, it is right to do the SNB, but be aware that In some cases when the sentinel nodes are positive, the AND yields only negative results. Although I appreciate my BS's thoroughness, it still irritates me that I lost 20 prefectly good nodes, and had to put up with the side effects of the AND,  for nothing.

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