Lymph node in breast = LE risk?

Hmmm...I hope Kira will come by to clarify. I believe we all have nodes in the part of the breast that extends closest to the armpit (one node each side I think), and I read somewhere that about 10% of women have additional nodes elsewhere in the breast.  More nodes removed = more LE risk.

Ask your BS to talk more about SNB.  It doesn't necessarily mean only one node is removed.  My SNB required 5 nodes to be removed; it was explained to me that the dye traveling from my point of concern to the 'sentinel' node lit up five nodes at one time--the pathway was not sequential. They were all pathologically clear, but all needed to be checked to find that out.  I think that it is somewhat common for SNB to require multiple nodes, and of course, the more nodes, the greater your LE risk.

So...be sure to also discuss with BS  the LE precautions you can take.  Request a pre-surgery baseline arm measure on that side (to facilitate the most prompt LE diagnosis if it does develop; early treatment = better outcomes and best chance the LE stays mild). 

Ask BS to order arm precautions on the SNB side, even if only one node is removed (my BS didn't believe in arm precautions if 'only' an SNB and I woke up with a BP cuff on my arm). 

Ask BS if he/she is up to date on LE research that suggests there's a small window of time after surgery, when lymphatics may heal. For that reason, it's best to delay for 10 days to two weeks any arm reaching, stretching, range of motion exercises that require putting that arm above shoulder level.  Studies show that waiting ten days to begin those exercises reduces LE risk and does not result in any diminished shoulder/arm capacity or ROM compared to those who do the exercises immediately after surgery.

If I got the breast anatomy wrong here, I'm pretty sure someone will be by to help with better information.  Google 'tail of spence' to read about the common breast node.

Best wishes, Chris.  It's great that you are questioning your LE risk before surgery. Wish I had.

Carol

LindaLou, wow...crystal clear and comprehensive explanation of breast nodes and related risk. I learned something here!  Thank you...

Carol

 Chris13 wrote:

Kinda depressing, tho'...I can never carry grocery bags again, get a manicure, etc. I also have an online business that involves shipping packages 4-6 pounds.

Chris, never say never!   We do have to think about many of our actions now before doing them, find alternative, safer methods for doing the things we like to do, but there are very few things that are absolutely contraindicated in persons with LE.

Part of the secret is becoming more aware of where the risks lie and having a game plan ready for how you will deal with those risks in advance.  There is no reason you should not be able to carry grocery bags or lift 4-6lb packages if you have taken steps to make that a safe activity.  If you learn to approach any new activity with the mindset of taking baby steps, gradually working up to a level that your body tolerates or that you are able to adequately manage without serious LE repercussions, you will find success in many areas.

Our human bodies require a certain level of movement and exercise to stay healthy, maintain good muscle tone and strength.  None of us should have to give up any more strength or flexibility than we already have due to SE's of surgery, radiation, chemo and hormonal meds.  We have to be patient and smart about it, but we can regain much that has been lost.  There have been tons of discussions on this board about LE and exercise.  You will find many of our swell sisters leading extremely active, strong, healthy lives because they know their bodies well, learn to cautiously increase their efforts and proactively take the steps to reduce risk whenever they can.

Regarding manicures, the biggest issue there is getting an infection from cross contaminated instruments used between clients.  There are many women who regularly get professional manicures but have purchased their own private set of instruments which they take with them to each manicure session.  Any soaking solutions should be changed out for fresh also in the salon.  I believe that false nails may be ill advised because of the risk of damage to the fragile cuticle area plus the moist environment created under the nail is a perfect breeding ground.  But a good nail trim and polish is certainly possible when done with safety measures in place.

Chris, regarding your hands puffing up there could be many issues at play here.  If you experienced hand puffiness before you ever had any surgery or cancer treatments involving your lymph nodes, it was most likely not lymphedema at that time.  For most of us, hot, humid weather increases the capillary blood flow in our bodies and can result in some extra fluid rentention in our extremities.  Also high salt intake in our diets, menstrual cycles and certain medications can result in edema which is the result of extra water in the tissues.  This type of swelling is NOT lymphedema.

Any swelling, tight rings etc that occur after a person has had lymph node removal, breast surgery or radiation should at least be suspect for early lymphedema.  Edema from lymphatic fluid is not the same as water edema and must be treated differently. A qualified LE therapist should be consulted for evaluation and measurements if the possibility of LE exists. I am not sure of your surgical history so whether you have a current risk for LE or not I don't know.  With your planned UMX and SNB you will then have a risk for LE but hopefully with the knowledge you are gaining now and risk prevention steps you can take, that risk will be lessened.