Remove more nodes or not?

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seaniebopp
seaniebopp Member Posts: 41
edited June 2014 in Lymphedema

I recently found out that of the three nodes removed one had 1 cm of cancer and another had .5 cm of cancer (the 3rd was clear).  Now I  do not know if I should have more nodes removed during MX.  Any and all information and suggestions are needed.

Thank you all!

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  • Holeinone
    Holeinone Member Posts: 2,478
    edited January 2014

    seaniebopp, did they do a Pet or CT scan? I had 7 removed, 6 full of cancer, growing also on the outside. Yikes ! Another node showed up on the Pet scan...looks inflamed, suspicious...I am hoping for better answers next week.. Did 8 dense dose chemo, had 12 zaps of rads..so, talk to your surgeon, or radiologist, whomever is in charge.. If your scans are clean then no.

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  • J9W
    J9W Member Posts: 395
    edited January 2014

    I'm wondering why more would need to be removed since it's already established that cancer was found in some. Does the plan of attack change with the more nodes involved?

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  • seaniebopp
    seaniebopp Member Posts: 41
    edited January 2014


    Yes they did do PET/CT scan and found one enlarged node on both sides.  I think they want to remove more nodes in an attempt to be sure that all cancer has been removed from the area.  I just do not want to risk Lymphedema by removing more but I hear that rads can also cause lymphedema.  Im so confused about what to do...

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited January 2014

    J9W - yes, it does.  Leaving known cancerous nodes in place can be akin to leaving a breast lump in the breast without removal - a .5cm node is equivalent to a stage I breast lump.  Chemotherapy and radiation do not necessarily eradicate all cancer from the nodes - and this situation is different from leaving a micromet in place, which some might consider to be node negative.  In the case of the OP there needs to be more diagnostic assessment to determine whether more malignant nodes remain.

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  • Holeinone
    Holeinone Member Posts: 2,478
    edited January 2014

    J9W, having cancer riddled nodes is very similar to the lump in your breast, you want it removed so it does not spread to lungs, liver, brain...Now the thinking for a lot of surgeons is to take fewer nodes, to help prevent lymphdema...yes, if you have more nodes involved you need more aggressive treatment, chemo, rads, hormonals...

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  • dogsandjogs
    dogsandjogs Member Posts: 1,907
    edited January 2014

    My surgeon told me if my sentinel node was positive he would not remove any others because there would be no point.  I guess there are different schools of thought on this.

    Luckily my sentinel node was cancer-free.

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  • Katiejane
    Katiejane Member Posts: 789
    edited January 2014

      My goal was to be cancer free- I had 3 positive nodes. Several more nodes were removed and I also had chemo and 25 Rads. Yes, I did develope lymphedema, I have been hospitalized x3 for cellulitis/ sepsis but at a little more than 6.5 years cancer free , I'd do the same thing all over again!!!  It's a personal choice and I wanted to have all odds in my favor!  Lymphedema sucks but I am still alive and living life to its fullest!  I wish you the best! Katiejane

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  • Quasi
    Quasi Member Posts: 44
    edited January 2014

    I am not a doctor so this is not a medical opinion. My MO told me that nodes are now used for staging and prognosis. There is research out there to suggest that either radiation or dissection can be used to handle affected nodes. According to this research radiation was associated with a lower risk of lymphedema. You can discuss this option with your doctor or RO, unfortunately I was not given that option my BS found that my SLN (2/3) were affected and he removed level 1 (3/12 was the end total). I am still upset with him because I was not given the choice to consult with a RO, his response was that if I wanted to wait he would have had to have a separate procedure for ALND. For me I had everything done at the same time - RX, SLN Biopsy, then ALND and finally LD flap reconstruction. The end result is that radiation seems to be an option - look into that and discuss it with your doctor.

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  • toomuch
    toomuch Member Posts: 901
    edited January 2014

    seaniebop - Here's a link to the article that compared AND to radiation with regard to lymphedema in women with a positive sent sentinel node:

    http://www.breastcancer.org/research-news/20131107-2

    It is impossible to tell from this summery how much cancer was in the sentinel node. I had a positive sentinel node so my BS did a AND at the time of my initial surgery. It turns out that I had 2/12 positive nodes. The sentinel node was a whopping 2 cm and the other positive node was 1 cm. Both had extracapsular extension. This study came out after my surgery but with the size of my SN, I still would have opted to have the AND. I still had radiation to my breast, chest wall, axilla and supraclavicular nodes. I think that radiation was a very important component of my treatment and I would do it again.

    I do have LE and it is a pain. I have to do MLD, manual lymph drainage daily and wear a sleeve/glove every day and a night sleeve at night. It is time consuming to keep under control but I find if I do all the things I should, I can keep it under really good control. Regardless if you choose to have more surgery or radiation, you should request a referral to a certified lymphedema therapist for an evaluation. It is recommended that you have baseline measurements of your arm so that you can be monitored for LE.


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