Did your nodes show on imaging?

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_Ann_
_Ann_ Member Posts: 769
edited June 2014 in Stage III Breast Cancer

Hi, 

I have four axillary lymph nodes showing as abnormal on PET/CT scan, with a palpable lump. FNA biopsy confirmed malignancy. So I am sure I am node positive, but I'm having neoadjuvant chemo, so I will not get an accurate node count from surgery. I wondered if anyone who had surgery first can tell me:

Did your nodes show on imaging? How many? Was the actual count after surgery a lot higher?

(I also posted on IDC forum.  Sorry for the duplicate-- I'm not sure where this belongs.)

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited July 2012

    My 2 positive nodes did not show on any pre-surgical imaging - mammo/ultrasound/MRI, and my 2cm tumor did not show on mammo.  The positive SNB was discovered in post-op pathology (SNB had been declared clear in the OR), and my surgeon and MO insisted on axillary node dissection which revealed a much larger positive node further up the chain.

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  • pupmom
    pupmom Member Posts: 5,068
    edited July 2012

    My 2 nodes were missed on mammos, MRI, CT and ultrasound testing. Radiologist said he did not think any nodes were involved. SNB revealed 2 with micromets. Crap shoot.

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  • mammalou
    mammalou Member Posts: 823
    edited July 2012

    My node did show on a pet scan, but it was also very involved.

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  • Momine
    Momine Member Posts: 7,859
    edited July 2012

    I had two palpable nodes when DXed, one was a centimeter, the other a half centimeter.



    No nodes lit up on the scans.



    During neo-adjuvant chemo, the smaller of the two nodes shrunk.



    After surgery, 7 nodes had cancer in them, but the big one that didn't shrink was just inflamed.



    So, I think it is a bit of a crap shoot.

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  • sweetbean
    sweetbean Member Posts: 1,931
    edited July 2012

    Yup!  I had two nodes - 1.9cm and 1.3 that showed on ultrasound and MRI.  Eeeeeeek!  Them's some big, cancery nodes.

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  • kathleen1966
    kathleen1966 Member Posts: 793
    edited July 2012

    I am one who did not have nodes show up on ultrasound, CT scan, MRI and one slightly lit up node on a PET scan. This same node was listed as appearing benign on the CT portion of the PET scan. I even had what the radiologist deemed as "if any of these nodes had cancer, this would be the one" tested after an ultrasound and it came back with no cancer. I was stage I going into surgery. I came out of surgery with four nodes and Lymph vascular invasion and was then stage IIIa. You know you have nodes, but you will really never know how many as you are having chemo first.  But you will hopefully be able to see these nodes shrink and possibly be brought to complete response. It is good to know that treatment is working because if it doesn't, they can try something else.  I may know accurately how many nodes I had, but I will never really know that treatment worked for me. I know it is very, very hard not to worry about those nodes, and you will spend a lot of time in the near future thinking about them.  But try to think of them as helping determine how aggressive your treatment will be. All we can do is accept the only treatment they have to offer us at the time and hope for the best outcome.

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  • diana50
    diana50 Member Posts: 2,134
    edited July 2012

    none of my 10 positive nodes showed up on imaging.  it was during surgery when fully encased nodes showed up.

    i know, sad.

    hang in

    d

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  • _Ann_
    _Ann_ Member Posts: 769
    edited July 2012

    Thanks for the replies.  Sweetbean you made me laugh at "them's some big, cancery nodes".  Indeed.  I think my largest was over 2 cm on ultrasound.  My breast lump has shrunk a bit already from first chemo but the nodes haven't changed yet.  I think I can actually feel some new ones. Eeeek!  I hope the next 3 rounds of AC knock them out.

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  • sugarplum
    sugarplum Member Posts: 318
    edited July 2012

    Hi Ann - I had a couple of nodes show up on my baseline CT scan prior to surgery - my surgeon reassured me, saying it could just be drainage from my recent biopsy. At surgery my sentinal nodes were lit up so they removed 20 total - 10 were positive with extranodal extension plus skin involvement - none of this showed on my annual mammograms. I guess they never really know until they actually get in there...

    Julie 

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  • _Ann_
    _Ann_ Member Posts: 769
    edited July 2012

    Yipes sugarplum, sorry you ended up with that unpleasant news after surgery.  

    I got the same story from one surgeon about my palpable nodes-- he said oh they're rubbery and mobile, so it's just a biopsy reaction.  Two MO's suspected differently and the MO's were correct.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited July 2012

    Those nodes are tricky little buggers, aren' they!  My nodes were "clear" initially.  I was told "there is no node involvement"  after diagnostic mammo and ultra sound, even though they told me my tumor showed as "4.8" cm.  Then surgery and SNB.  Surgeon said nodes looked to be free of cancer.  Then pathology came back with positive cells for cancerUndecided on SNB. So following week axillary node dissection done and17 more nodes were removed with total of 2 nodes being positive for cancer.  Tumor also turned out to be 5.2 cm.  So until surgery is done and pathology is done, we just don't know.

    image

     Barb

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  • Rockym
    Rockym Member Posts: 1,261
    edited July 2012

    No nodes were involved on my imaging.  During surgery my SN was clear.  I was a happy camper because for me a clear SN meant no chemo.  After my final pathology came back it showed 2 nodes with micromets.  I still wasn't keen on chemo, but when the oncotype came back 22 and I remembered what the MO said which was "you only have one shot at this because if the cancer has gone anywhere else, you won't have this chance again.

    Still waiting for life to feel normal again.

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  • vacationbound
    vacationbound Member Posts: 171
    edited July 2012

    There are two different staging criterias-one is clinical the other is pathological, the definitive is the pathology report (post surgery) My nodes were never detected clinically, only after surgery were they confirmed.

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  • Elizabeth1959
    Elizabeth1959 Member Posts: 346
    edited July 2012

    My one lymph node was not palpable and not visible on US or MRI. For that matter, neither was most of my tumor. As far as I'm concerned , imaging is in its infancy.

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  • wildrumara
    wildrumara Member Posts: 450
    edited July 2012

    My two positive nodes never showed up on mammo, ultrasound, MRI, or PET scan (all done at diagnosis or shortly after for staging).  I then had neoadjuvant chemo, with a follow-up MRI and still no "lymphadenopathy"  or enlarged lymph nodes seen.  When I had my BMX after chemo, surgeon did SNB and while under anesthesia, pathologist looked at the two sentinel nodes and they were POSITIVE, just crossing the metastatic threshold at 0.2 cm and 0.25 cm).   Breast surgeon then proceeded with ALND......rest of the nodes were negative without any evidence of necrotic tissue in any of the nodes, which hopefully means they were always negative!   I was hoping to have a complete pathologic response, but knew ahead of time that ER positive, grade 2 tumors don't normally have a great response to chemotherapy......my tumors did shrink nicely, but obviously, who knows what was truly going on in those nodes.  This has weighed heavily on my mind for quite some time, but I'm hoping that Tamoxifen is going to keep me NED for years! 

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  • faithfulheart
    faithfulheart Member Posts: 544
    edited July 2012

    I had 2 nodes show up on MRI, Pet Ct Ultra sound and Mammo............So we knew I had 2, not so bad i thiught???? However I chose to have surgury first, my tumor was large and I just wanted it out.............They found 10 pos nodes for cancer one being over 2cm......ouch!!!! I was grateful that I had surgury first due to treatment plan................So right very trickey those nodes!!!

    xo 

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  • jennyboog
    jennyboog Member Posts: 1,322
    edited July 2012

    My nodes did show on imaging (MRI & pet), never gave a number though, report just read "several".  I did neoadj. and at surgery the report read, residual cancer cells in 5 of 16.  I don't know exactly how many were ever infected, I'd like to think it was just 5 and the chemo did its job.  If there were more infected atlest I know chemo was working.

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  • TectonicShift
    TectonicShift Member Posts: 752
    edited September 2013

    I had 11 nodes with cancer, some of them BIG -- and none were palpable and none showed up on presurgery ultrasound or MRI.

    It scares me, because how do I know I'm not stage IV?

    All the body scans were clean, but so were the ultrasound and MRI on my axillary nodes and they turned out to be full of cancer.

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  • tlundy
    tlundy Member Posts: 142
    edited July 2012

    I had surgery before treatment, as MRI and two subsequent biopsies of nodes came back clean. All doctors thought Stage I until path report came back after surgery; 5 of 22 nodes positive - IIIA, so I didn't begin chemo until after my BMX.  Unfortunately, it seems that with all the imaging technology they really don't know until they actually operate.  Good luck and hugs! 

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  • pupfoster1
    pupfoster1 Member Posts: 1,484
    edited July 2012

    Sorry to hear about your dx, but you will get great support here.  None of my nodes "lit up" on my pre surgery scans, but I could tell something was going on there.  Felt like a tugging and pulling kind of pain.  I had to wait 7 weeks for my surgery and all the while they kept saying, oh we don't feel anything there, your scans didn't show anything.  Well so much for that bs---13 out of 15 positive nodes.  BLAH.  Gotta have faith the chemo/rads knocked out anything that might have tried to get loose.

    Hang in there, we'll be right here for you!

    Sharon

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  • lkc
    lkc Member Posts: 1,203
    edited July 2012

    nodes are tricky on all types of scans. It's very unreliable, as enlarged nodes can be just inflammed and small nodes can be bad. I had 12 positive nodes 2 of which were totally replaced by tumor and NONE showed up on my presurgical PET scan.

    In retrospect, I think surgeons and Onc's should explain this upfront so there isn't so much confusion.

    pathological biopsy is the ONLY way to confirm if a node is neg or pos.

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  • Denise-G
    Denise-G Member Posts: 1,777
    edited August 2012

    My nodes showed up on Mammogram, Ultra Sound, CT Scan and MRI.  My initial pathology report from Mammogram and Ultra Sound said there were positive nodes.  When my GP told me that report, I was mad and didn't believe they could see them on those tests.  But mine they did.

    The nodes were clumped together, so I never really asked how many during the scan stages as I was too terrified.  Since I knew of node involvement, I was more afraid of the organs they were looking at for Stage IV as hot spots showed up on bone scan and CT Scans.  Turned out it was okay except nodes.  Just talking about it the fear is so intense 10 months later! 

    I had a single Mastectomy before chemo.  When they told me I had 9 out of 14 nodes, I was relieved as I thought there were more.  My Breast Surgeon said there were no surprises as they knew what they were dealing with before going in. 

    I never knew until this week while reading a forum that some people are Stage IV with no positive nodes!   So I am thankful my nodes caught it.

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  • NancyD
    NancyD Member Posts: 3,562
    edited August 2012

    I had two nodes that showed up on imaging, and confirmed as IDC with the core needle biopsy that was done at the same time as the lump biopsy. Neoadjuvant chemo reduced the lump considerably, but two more nodes were determined cancerous in post-op pathology after my BMX. One of the original two had extra nodal extension and I wondered if it was caused by the puncture of the core biopsy needle.



    My MO recommended two more rounds of chemo after the surgery.

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  • MandalaB
    MandalaB Member Posts: 111
    edited August 2012
    My lymph node being giant is how I found my breast cancer.

    I can feel it, and on the MRI and ultrasounds, it is a big and bright.

    A giant lit up clump of christmas lights.

    I hate feeling it now. It is scary as hell .....
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  • anneflorida
    anneflorida Member Posts: 59
    edited August 2012

    When I had my ultrasound biopsy, they biopsied one lymph node that could be palpated.  It showed cancer.  My PET scan showed one lymph node but after surgery I had 9 out of 28 with cancer.  I am now than 2 years out from the end of surgery, chemo, and radiation and still NED.

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