SNB questions need help

Options
rosierosie
rosierosie Member Posts: 71
edited February 2016 in Surgery - Before, During, and After

I am going for a lumpectomy on Friday I have low grade nuclear non invasive DCIS, my doctor wants me to have SNB he said that is his procedure, I read a lot about this and its says you normal do not get SNB for low grade DCIS. He a very good surgeon, should I be worried about having this procedure, he said some hospitals stoped doing this but he prefers to do it. When I called the hospital they said it a standard of care procedure, something like that. I am a bundle of nerves so scared of the SNB I don't want to call him again and questions his ability. Is this SNB procedure normal and I should just chill out. If anyone who has had the SNB please advise. Nervous in New York thank you so much for any insight

· Share on FacebookShare on Twitter

Comments

  • Numb
    Numb Member Posts: 432
    edited February 2016

    You don't have to be worried about sentinel node biopsy operation.  It is a way to be sure that your cancer has not spread to your lymph nodes.   It is better to be safe than sorry, and that is how I would look at it.  It is not a major op and is quite simple.  I had it last week with 2 nodes removed, so you might as well have this done if it is on offer Rosie.  Fear not.

    · Share on FacebookShare on Twitter
  • BayouBabe
    BayouBabe Member Posts: 2,221
    edited February 2016

    Rosierosie - I think you have every right to question this. Just because the surgeon 'prefers' to do this, does not necessarily make it right for you and your personal cancer characteristics. I say this, not to scare you, but to share my experience. I had ONE node removed and developed lymphedema. I had no choice about the SNB, due to my mastectomy and invasive cancer. However, I question everything and encourage everyone else to do the same. Ultimately, the choice is yours. Research, question, get another opinion. Just because a surgeon 'prefers' or has always done things this way, doesn't mean it is necessarily right for you or is the way things should still be done.

    · Share on FacebookShare on Twitter
  • SpecialK
    SpecialK Member Posts: 16,486
    edited February 2016

    SNB is more mandatory if you are having a mastectomy since it requires breast tissue to perform. Once the breast tissue is removed it is exceedingly difficult to identify the sentinel node. If you are having a lumpectomy, and pure DCIS is your preliminary diagnosis, it is not necessarily mandatory to have a SNB done.  Should an invasive component be discovered in post-surgical pathology, you can go back and have a SNB since you will still have breast tissue.  If you feel strongly that you don't want this procedure your surgeon can't insist that the SNB be done, but expect some resistance and require an explanation for why he is insistent when this can be done later should it be necessary.  You would be subjecting yourself to additional anesthetic, and further surgical risks to do it later - and I am imagining that is what his point will be.  However, if you do have pure DCIS, with no invasive component, you are subjecting yourself to more risk for nerve damage and lymphedema, which should be your counterpoint.

    · Share on FacebookShare on Twitter
  • rosierosie
    rosierosie Member Posts: 71
    edited February 2016

    I did talk to him and mention by fear of lymphedema, he said this would not happen because he was only taken one node out. He said I would be fine this is how this hospital does it. if i dont get it done I have the fear of having cancer. maybe he sees something that I don't know I just wish it was over with. Do I call him again? my surgery is Friday He told me not to read everything on the internet he knows what he is doing. What would I say to him i dont want the surgery cancelled. I dont think he would put me in danger. He has very good credentials, he is on board of surgery and a liason for breast cancer in hosp. thank you for your advice


    · Share on FacebookShare on Twitter
  • BayouBabe
    BayouBabe Member Posts: 2,221
    edited February 2016

    Just remember no matter how much he promises you will not get lymphedema with only one node removed, there is absolutely NO way he can guarantee this. I am proof, as this is what I was told as well. If he would cancel the surgery, because you would refuse the SNB, you are probably better off with another surgeon anyway.

    · Share on FacebookShare on Twitter
  • LisaAlissa
    LisaAlissa Member Posts: 1,092
    edited February 2016

    And, BTW, I had a lumectomy and a SNB. The SNB was the source of most of the post-surgery pain. I was asked to sign off on the SNB just before I went in to surgery. My surgeon described it as a "minor" procedure that would let us make sure that I didn't have "occult IDC that was spreading" that we didn't know about. (My diagnosis, like yours, was DCIS--although mine was thought to be mid-grade before surgery. (The post-surgery path report upgraded that to high grade.)

    Based on that description, I consented. I don't have lymphedema (one of the major--although not frequent--risks of SNB), but it took me years to recover full use of my arm/shoulder. If I knew then what I know now, I wouldn't do it.

    Yes, have the discussion with your surgeon, but if you're not at a NCIC-designated cancer center, consider getting a second opinion at one.

    It sounds like your surgeon may have developed his own "standard of care" at his hospital. But it isn't standard of care anymore to get a SNB with a lumpectomy for DCIS anymore unless there are other factors involved. Things like placement of the DCIS that would make a later SNB difficult/impossible. And even then, people are now placing a titanium clip to ID the SN(s). But not removing them unless the diagnostic info they can provide is needed later.

    I'd go with your instincts.

    Best wishes,

    LisaAlissa

    · Share on FacebookShare on Twitter

Categories