SNB VS AXILLARY NODE-Help

I know you're scared, but please try to stay calm. 

SNB is the removal of the first couple of lymph nodes that cancer is likely to spread to from the primary tumor. It's a much less invasive procedure than an axillary removal, which takes out all (or almost all) of the nodes. 

I believe it is protocol for all BC patients, even stage 0, to have a node biopsy.  I would think that your doctor reached the conclusion that you were stage 0 based on the core biopsy results. Take this one step at a time and don't jump to conclusions.

I had a SNB last year and honestly, it wasn't painful at all. Before the injections, the radiologist put some lidocaine on each of the areas that were going to be stuck with the needle and I didn't feel anything. I also didn't look at all - kept my eyes close the entire time because I'm very squeemish.  The only thing about the SNB preparation that bugged me was the CT scan - I'm a little claustrophobic and at one point the nurse left the room for about 10 minutes with the scan hanging about 12 inches over my head. But really, that was the worst of it.

After the SNB, my underarm was sore and as the wound began to heal, it felt tight - it was more annoying than painful. Make sure you have some ice packs on hand - it will help with the swelling. My surgery was on a Tuesday, I returned to work on Thursday and went away for the weeked a couple of days later, on friday. I was sore and and a little swollen, but overall I felt fine. 

 Like you, I was panicking beforehand - I hate needles, hospitals, doctors . . . but it really wasn't terrible. It's going to be okay.

Best,

J

Also wanted to add just asked my surgeon the other day same question you asked which is why no number grade on path report (mine just said intermediate grade)  and he said they only use numbers with invasive cancers (not DCIS) so my understanding was mine was about a 2

After you get over the shock of it all go onto the DCIS forum where there is lots of helpful info, see especially posts from Beesie

SNB carries lower risk for lympedema than axillary node so that is a good thing

good luck 

when you are on the home page go to the white box on the upper right which says "jump to a forum" and arrow down until you get to DCIS and click "go"

that will bring up all the threads under DCIS As you will see there's a lot there (over 50 pages)

If you find a thread that's helpful to you click on box to save as a favorite topic so you don't have to scroll thru everything again to find it

good luck

There is a lot of really good advice on this thread, but there is one point I want to correct.  Re the comment above:

I believe it is protocol for all BC patients, even stage 0, to have a node biopsy. 

 While there are many people with a DCIS diagnosis who will need to have a SNB, it is NOT protocol for all DCIS patients, Stage 0 patients. I just want to point this out in case someone with a new diagnosis is worrying because she is not scheduled to have an SNB. 

 DCIS patients generally do have an SNB if they have mastectomy and sometimes (under special circumstances) if they have lumpectomy.  But the majority of people who have DCIS diagnosis and who elect to have a lumpectomy, DO NOT have SNB.  If you are concerned, ask your doctor specifically why he is she is recommending an SNB in your case.   

Psalms91-  I had a bmx with immediate recon - a DIEP.  A SNB takes about 4-5 days to come back.  The recon procecures are very workable with an experienced PS.  This is worth hunting for, interviewing, looking at websites, asking questions over on the reconstruction site.  Lots of things to think through.  The sites for PRMA in San Antonio and www.breastcenter.com have great photos.

If you have only DCIS it has not spread outside the breast and they would not need to check the nodes.  If you have a lumpectomy, they do not usually check nodes.  For those patients who turn out to have an invasive component in addition to the DCIS they can do the SNB later.  However, if you have a mastectomy the standard procedure is to do a SNB even for DCIS because some patients will have an invasive component found along with the DCIS.  That would mean SNB is necessary, but once the breast is gone the SNB is not possible (no place to inject the dye and follow the path to the sentinel nodes).  If the SNB were not done with the mastectomy, an axillary node dissection (AND) with many nodes removed would be necessary. 

The study Jane cites is looking at the question of what should be done if the SNB finds a positive node.  Standard procedure would be to go back and do the full AND.  Does that improve outcome?  As a research question it is hard to show that one step in the whole diagnosis and treatment process makes a difference in survival.  An intermediate question is, "Do the results affect treatment decisions?"  The answer is probably "no", if they would recommend radiation therapy because of the single positive node.  It has been somewhat controversial whether radiation should be given for a single positive node but the evidence is moving toward that recommendation.  So... if you have the same treatment recommendations whether you have the follow-up AND or not, the AND is not necessary. 

The point is that SNB is much more limited surgery than AND with lower risk of lymphedema and other side effects.  They are trying to reduce using AND.

Yes I had tissue expanders placed at the same time they did the mastectomy. I went through the expansion process, and have had the exchange surgery in April. The PS made nipples at the time of the exchange so all I have left to do is the tattoos. We'll do those in October, and then all done!  

hi everyone

a little late but i know now the sentinel node and axillary node is one of the same (i think) going to dr #3 on wed. and onc next week.still dont know anyting yet.every dr.says something different.i ma just fed up.

thanks for all your help.

I PRAY EVERYDAY FOR A CURE FOR CANCER.

love my sistas

K