Poll on Sentinel Node Biopsy Pain

Kalina, you're so welcome! I truly do understand that horrible fear you've been feeling. I actually had a name for it when I was at the stage where you are now "The Jaws Music!", you know the menacing music that comes in da dum, da dum! Silly, I know, but the fear would get me, when I least expected it. da dum! LOL

You ask for whatever you need, to get you through. I am not good with meds, so prefer to go au natural, but that's not for everyone either!

Try to relax as much as you can for the procedure, my technician talked me through it and I managed to imagine myself melting into the table, taking nice cleansing breaths. The injections for the procedure are quick, for me, the node wouldn't light up, so I had to massage the tracer through and have several scans before the node lit up. As soon as it did light  up my Tech shouted "Got it' high 5'd me and he ran me up stairs to the operating suite.

I swear, I felt like I was bullet proof, all that fear for nothing. The Mx was also pain free and I was home in my own bed the next day!

I will be thinking of you and will look forward to hearing how you get on. Hugs to you!  M x

Erinsoule, I am so pleased I could help, just a bit. It is hard to stand by and see others in such pain and so scared. I remember it so well myself, and others here came to talk me down off the ledge, so to speak! LOL 

It is a wonderful thing to have the love and the support of family and friends, but you're right, unless they have actually walked this path before you, they are looking for signs from you, not a bad thing, but not the same as interacting with someone who has "Felt the fear!" It is a club that no one wants to join, but the support and the genuine caring from women here, who come to pay it forward after their own experience, is just what we need at this precarious time.

I think we all want our own rabbit hole, mine was long walks with my dog along deserted beaches where I live. 

You will get through this and then you'll be here, giving your experience and support to someone else, who is looking for a rabbit hole!

I wish you all the very best, it won't be long till you're on this side, looking back! Hugs M x 

I don't know why it isn't done that way for everyone either.

There have been many, many discussions on this topic in the 18 months or so that I have been here. There have been many ideas thrown around, as to why some have a bad experience, and others, like me, have absolutely no issue at all.

Some believe it is to do with the PH of the tracer, the temperature of the tracer, the size of the needles, the pain threshold of the patient, the area injected and of course, the experience of the technician performing the procedure. 

I knew beforehand, that my first stop at the Hospital, on the morning of my Mx was at the imaging department, for the tracer and the scan for my SNB. My Surgeon had explained the whole procedure and told me that the blue dye would be injected in the OR, after I was anesthetized. There was never any indication of another option. He had even agreed that I could have a numbing injection first if I wanted it, he couldn't really understand why, because he said it shouldn't be a painful procedure. It turned out the tech wasn't qualified to give the numbing injection and even called my Surgeon at home. My Surgeon actually offered to come down to administer the injection himself. I was mortified that he would have to do that before he had a full day of surgery ahead, so I opted out. I am so glad I went without, because I certainly didn't need it.

When I was chatting to the team right before my Surgery, my Surgeon asked me how it had gone and when I told him there was no pain at all, he said that was what he expected, he hadn't had any patients tell him it was a painful procedure. Again, I don't know why.

I don't know if we will ever find out what the differences are, that can make this procedure painless, or  painful.

The pain was pretty bad at times and usually when I least expected it.  Once I started PT with a lymphedema specialist, it all got better.  Massage definitely helped, but it took time.  Best of luck to you!

Ariom....born in Willie town NSW but spent most of my early years in northern South Australia. Live in the US now. Get home at least once every two years. Miss it like heck and will be retiring there soon. Cant wait!!

My mother had this procedure done this morning. She was terrified.. she was more worried about this than the actual Uni MX that was scheduled after. I really thought she would lose it over this. She went in for the procedure and basically assaulted the technician with wanting a numbing agent. The lady was a bit taken a back, but I told her about what was conveyed to others of the possibly pain factor. The lady informed us that the tracer was mixed with lidocain and would have very little discomfort at all.. she promised. She was aware that some hospitals did not do this and had also heard that it was very painful. My mother was still very anxious but decided to trust her (or figure there was no other choice) she had the injection. It was one long injection, but the discomfort was very minimal (and my mom is not big on pain). I am just thinking if my mom had not voiced her concern she would of had one simple injection and thought she just got lucky, but I have to think that the lidocain mixed the tracer made all the difference and she was almost giddy when leaving nuclear medicine to go for her surgery.. thinking she got past the worse part.

Hi Veronicafrances! You are the first I have ever heard of, who has had a general anesthetic, for this procedure. I am assuming this wasn't simply having the tracer & scan done, for the sentinel node location, (SNB) prior to Lx or Mx. Was this done just prior to a surgery, or are you having a surgery in the coming days?

Please forgive me, for all the questions, but this is not something that is offered where I am. My SNB was totally painless, but as you can see from this thread, it isn't that way for everyone. It is always interesting to see how things are done differently in other countries.

I wish you all the very best with your recovery.!

I'd like to share my experience too in Singapore. I was injected with a radioisotope at the hospital's nuclear medicine department an hour before my bilateral mastectomy. I felt a pinch when I was injected but thats about it. No other pain.The nurse had to massage my boob to help the radio isotope travel to the SN. I was scanned to make sure it has. Then I was sent to the Operating Theatre. In the OR, I was told they also injected a blue dye while I was knocked out to confirm the sentinel node the radio isotope travelled to.

Donna Dew, this is a very hotly debated issue and the experiences are honestly, like night and day.

When I was scared out of my wits, by 2 women who told me their horror stories about their SNB, I went to my surgeon, to tell him I was terrified by these reports. He genuinely tried to calm me down, but told me in all his years of doing this surgery, in 3 different countries, he had never had a patient tell him of a really bad experience, with this procedure. He offered me anything I wanted, to numb my breast before the procedure.

I went in to have my tracer done a few hours before my Umx but the young technician who was doing my procedure wasn't cleared to use any lidocaine with the tracer, so he actually called my Surgeon at home, I was mortified when my Surgeon told the tech to hold on, he'd come to the Hospital right away, to give it to me, himself. I decided to go without, there was no way I wanted that Surgeon, who was going to be operating all day, come to the Hospital early, just because, I was scared.

As it turned out, I felt nothing, not the needles going in, I had 4 around the areola, or the fluid going in. I did have to do a lot of massage to get the tracer to go through to the node and there were several scans done, to try to find the node, but there was absolutely no pain or discomfort, at all. I really couldn't believe it, it's not like I was relaxed about it!

Why was it like this for me and so many others, yet some have a terrible, painful experience? I have no clue, I went in terrified, stressed and shaking and came out, feeling bulletproof!

I would love to see a study done on this, some say it is the PH of the tracer, the temperature, the size of the needle, the density of the breasts. There has to be some commonality which determines how this is experienced. Some say it's all about the pain tolerance, I don't believe that, because in order to tolerate the pain, you have to feel it and process it. I have Rheumatoid Arthritis and have a very high tolerance level, after nearly 20years and an aversion to taking the drugs, for this pain filled disease, but there was nothing when I had this procedure done.

In summing up, DonnaDew, there is every possibility that you'll have the same experience, that I and many others here have had. I know how easy it is to read both sides and then to focus on the really painful negative stories, I did that too.

I wish you and all the others who will come here and read this thread about SNB, a speedy and painless procedure.

Hi,

I also had the tracer before my lumpectomy and I am one that felt it was very painful. I had a wire locater put in right before that with nothing as they said the lidocain would hurt more than that wire and it wasn't that bad, but the tracer was to me. No one massaged the tracer- I had 4 shots around the nipple. I was told it would hurt a lil more than the wire locater- GRRRRR... not sure why lidocain was not suggested for that.

2 months later my sister( she was dx with the same size same location BC as I was just 2 months later after I bugged her to get a mammo over and over) she said it didn't hurt when they did the tracer for her. 

I also had more pain after surgery then she did- but they had to DIG for my sentinel node ( probably cause they didn't massage the breast) I did wake with many blue injection sites in my breast and peed like a smurf for 5 days- which I wasn't told about - I saw blue pee and freaked!!  So I warned my sister she told me it only lasted a day.  He ended up just taking lymph nodes and found two sendinal nodes which were clear. 9 total- My sister only had one removed, as they found hers right away.

I asked a very nice intern why I was having so much pain after surgery and he told me he has seen that younger woman tend to feel more pain than woman who are post menopause, as sensation in the breast changes after menopause.

 I was 44 and pre-menopausal and my sister was 60 so post- menopausal so maybe there is something in what he said?

I found an interesting article in which pain management during SNB was discussed and compared in two small groups (sample size 20 in each group), one of which received no pain relief, and the other, which had used EMLA cream. Each group was asked to report the degree of pain from 1-10, with 10 being the most painful thing ever experienced. The group with no pain relief generally reported pain of 8.8 and above, depending on the procedure, and the group using the cream reported much less pain. If you're interested, HERE is the link.

I'm scheduled to have SNB in mid-April, and am finding this discussion fascinating! My breast biopsy was nothing, and needles don't bother me at all, but if pain relief is offered, I'm jumping!

I had the cream applied and never felt a thing. I asked when they were going to inject the dye and the dr said "I already did!" This was Monday. Had lumpectomy and SNB. Some soreness but nothing worth medicating. My boob looks like I was in a massacre but it has been stabbed and sliced and injected so much over the last two weeks that it's bound to happen.

Christine

Thanks for linking to that study DiabeticCancerChick! I am relieved to see that ELMA cream can reduce a pain rating to 4 out of 10 ) Like you, I tolerated my core biopsies really well. But some ladies experiences with SNB are giving me flashbacks to my wire localization experience a few years back.

Hello gypsyjo! It's Tuesday afternoon here and I hope that things went better than you expected today. Please chime in here when you are feeling up to it to let us know how you made out! Honestly it kinda makes me mad that in this day in age we have to endure such invasive procedures. The diagnosis is bad enough, and surely the anxiety about the post-op pathoIogy is overwhelming enough too. The surgery itself is the easy part.

Marykatek, wow you are strong. I will keep the deep breathing in mind. I tend to hold my breath when I anticipate pain. Maybe I should take a squeeze ball in case I don't get such an understanding nurse. I recently heard about uterine biopsies, and how painful they are, yet another horrific procedure for us women. Honestly.

My nurse navigator emailed me back about SNB and the only thing she recommended would be to take tylenol or advil once I come to admitting the morning of my surgery. I can take clear fluids then but nothing else after admitting. I have to double-check about the advil since my family doctor told me no advil for a week before my surgery (because it is a blood thinner).

Hi everyone, I just had my second round with SNB. My first one I was terrified of and freely admit that despite guided imagery, deep breathing and calming meditation- I do work myself up for certain procedures. I asked my BS about Ativan the first time and she gave it to me no problem. It worked like a charm, I remember feeling the bee stings when injected around the nipple, but I was so relaxed that I did t perceive it as pain. This time around I asked for it again and was also advised to use emla cream. Well I put the emla cream around my nipple and covered with supplied bandage only to get to the hospital to find out my BS had sent recent instructions that she wanted the injections done by a Dr. around the tumour site instead of the nipple! I thankfully was given Ativan again and although it really reduced the pain, I did feel it more- maybe because my tumour was very sore to begin with. The procedure was very bearable but I don't think I could have done it without Ativan. I can't understand why a safe drug like this isn't offered for a procedure like this to everyone. You simply don't know where you are going to fall as far as pain until it's too late. Why not have something that will relax you and dull the perception of pain? Isn't this a more humane approach rather than guessing who is going to feel more pain than others

Gypsyjo - I hope your surgery went smoothly and that you'll have but a brief wait for an excellent pathology report!