Sentinel Node Biopsy

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pam53
pam53 Member Posts: 131

I was just diagnosed with IDC on 7/7.  I had an excisional biospy following stereotatic core biopsy for ADH cells.  Unfortunatley, more than ADH was found.  The tumor was small .4cm x .4cm x .6 cm.  Does that mean it is less than 1 cm?  It was Grade I.  I have to have sentinel node biopsy on 7/13.  Can anyone tell me what it is like?  Painful following?  What to expect?  I was reeling from the diagnosis and did not ask all the questions I should have.  ER, PR and HER were not back yet.  Thanks in advance for any responses. 

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  • dlb823
    dlb823 Member Posts: 9,430
    edited July 2011

    pmenz ~ Yes, your tumor is less than 1 cm.  They go by the longest side.  And Grade 1 is the least aggressive, so that's a very good thing!  And did the biopsy remove it all with clean margins?  (It sounds like it did, since you didn't mention future breast surgery.)

    For the sentinel node biopsy they normally inject a blue dye and trace it to figure out which is the sentinel node.  Some women have some pain with the injection (I didn't), and your breast surgeon will usually RX a mild pain reliever for the incision.  But in most cases, it's a simple procedure and quick recovery.

    That "reeling" you mentioned is pretty universal -- especially when the news is unexpected, as it sounds like yours was.  Having someone go with you at your app'ts. is a good idea, although it sounds like you never expected your app't. to have this kind of news.

    Good luck on the 13th!    Deanna 

      

  • YaYa5
    YaYa5 Member Posts: 667
    edited July 2011

    pmez, i had a sentinal node biopsy last month with my lumpectomy.  the BS took two nodes and it was really not that bad at all.  a little pain moving my arm up and down at first, but nothing i couldn't handle with a tylenol the first day or two.  it healed quickly.  no problems.  i was terrified of the procedure, but felt silly afterwards because it was so easy.  

     i know how hard it is to hear those words "cancer."  i was diagnosed in may and am still waiting on the oncotype to return and the waiting is hard.  i still don't know about whether i will have chemo, but my onco said it was highly probable.

    you're in a wonderful, kind and caring place here.  please keep us posted on your progress and good luck on the 13th.   

  • pam53
    pam53 Member Posts: 131
    edited July 2011

    Thanks for replying.  Yes, I got clear margins.  So, that ends further breast surgery.  I guess the name of that surgery has changed from an excisional biopsy to a lumpectomy based on the results.  I was curious why I see so much difference in the number of nodes removed.  I see you had 16!  Do you have any trouble with lymphodema?  My visit with the BS is a bit of a blur but I think she said something about average nodes 2.2 and that if it was more than 6 she would call the pathologist to the OR.  I do not know what he does in that circumstances.

  • peggy_j
    peggy_j Member Posts: 1,700
    edited July 2011

    pam53, yes, I can understand the reeling. My biospy showed IDC, so I had my SNB when I had my lumpectomy. Yes, some places use a blue dye to determine which nodes to remove. In my case, my BS sent me to nuclear medicine (yes) where they made 4 injections around my nipple. (these injections do sting, but they are over quickly). These injections drained into my lymph nodes and my BS used a Geiger counter to determine which lymph nodes. Sounds bizarre, I know. Anyway, the surgery was quick. In my case, they did the SNB first, then the lumpectomy. The pathologist was standing by and did a review of the nodes while the surgeon was doing the lumpectomy.  In my case, the nodes looked good, so they stitched me up. The pathologist then spent the next week studying the nodes in detail under the microscope. In my case, they were clean. In some cases, they find things while you're in surgery and remove more nodes while you're there. In some cases (5%?) the pathologist finds tiny microscopic things that following week and they may go back and do another surgery to remove more nodes. Since your tumor is so small, I think it's unlikely they are going to find anything in the nodes, so these other scenarios won't play out. But I think it definitely makes sense to do the surgery to know.  

    I've had no problems with lymphedema. If you're only getting a few nodes removed, most women don't have problems. (my surgeon said only 3-6% of women with SNB have lymphdema symptoms) I did take their advice on taking it easy (no lifting anything with that arm for 2-3 weeks.) I got a little pillow and that helped a lot. The first week I put it under my arm to help me sleep; when my arm started feeling better, I put the pillow under my arm during the day to remind me not to use it! (I started feeling better so quickly, I'd forget to avoid using that arm!) I'm sure it seems scary now and there's so much info to learn (I felt like I was getting a crash course in cancer 101). But for me, the surgery was a snap; much easier than dealing with the emotional stuff, to be honest. Good luck. You're going to do great!

  • IllinoisNative
    IllinoisNative Member Posts: 125
    edited July 2011

    My experience was the exactly the same as peggy's.  They did the SNB when they did the lumpectomy since they knew I had IDC.  I was also injected with the blue dye beforehand.  But they front-loaded the syringe with lidocaine so I felt nothing.

    In my case, they removed four nodes and were able to tell me that day, after a quick review, that it looked like the nodes were clear.  But they confirmed that a few days later.  The surgery was a breeze.  Frankly, I had a harder time with the port surgery.  I didn't even need pain meds.  I took it easy and didn't lift anything for a while.  It wasn't bad...and that was the first surgery I ever had in my life.  My anxiety was so much worse than the reality of it.  It wasn't bad at all.

    And my tumor was much larger than yours.  Good luck!

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