Poll on Sentinel Node Biopsy Pain

I'm very glad to hear it all went so well and that you're both happy with your team and feeling so much better! I agree that the waiting is very stressful and am glad you have at least some of it behind you and a definite date for your path. results. Try not to overdo it in the meantime just because you feel good!

Gentle cyber hugs.

PS - I'm amazed that you (and several other women) mention a nurse holding their hand during the procedure. My breast clinic is so lacking in human touches that I took my own stress ball along to squeeze during my 2nd round of biopsies.

Hey everyone I just wanted to thank everyone on this page for scaring the crapola out of me about the isotope injection, I had a BMX with TE reconstruction, but i was not the slightest bit worried about that. I was terribly worried about the injection, I was prepared for the worst pain of my life... Which I am glad for because I go in there expecting it to hurt like lava was being poured onto my chest while the devil was giving me a purple nurple! Guess what IT DIDN'T HURT. the IV hurt worse. now I have an incredibly High pain tolerance so maybe it was that, or maybe it was that I was over prepared for the expected pain. I don't know if you have ever had a TB skin test but that is what it felt like, it felt like a TB test on the breast. I felt the skin stretch a little but that was it. My advice to all those preparing for this procedure it to OVERPREPARE, then Go with the flow.

I have strong feelings about this subject. There is so much difference between how each instution administers this procedure and thus, it creates a lot of confusion about why some women experience so much pain and some women don't. Add to that the differences between women's pain thresholds and nipple sensitivity and this is the result. Confusion!

This doesn't have to be painful for ANY woman (or man)! I had a terrible experience so much so, have become an activist in my community to get this procedure standardized across all hospitals in our area. It was my surgeon who educated me about the differences. Trust me, no one should have to endure this unnecessary pain. If you had a painless experience, I am happy for you, but don't discount the experiences of others or think they are scaremongers.

Just like women were the catalysts for eliminating the radical mastectomy decades ago, we need to get mad about this!

Just wanted to chime in here with my experience. I had both children without any pain meds.

I have always had a very high pain tolerance but I tend to get extremely nervous when I think I'll be in pain. Odd, I know. So I read a ton about this injection and asked nurses at both my BS office and my PS office. Both of them had the same reaction, like it's the first time they've ever heard about anyone having any pain with this injection. My BS's nurse said that I wouldn't be sedated but that I would be given a lidacaine shot so I wouldn't feel anything. PS nurse was really confused about the possibility of this having any pain involved but assured me that since I would be going into surgery soon afterward that I would be well drugged.

Well, I was not drugged in any way shape or form when they rolled me into Nuclear Medicine which was dark and dreary. There, I was handed over to a sweet lady who asked me if I'd heard anything about this injection. I told her that I'd heard everything from it was nothing to it was the worst pain on earth. She said that was because everyone seems to have a different reaction. She assured me that she would be by my side with her hand to hold as the doctor administered the shot. He came and we pretty much had the same conversation and I asked if he was giving me a lidacaine shot or something first and he said that I had no orders for it and hospital policy required doctors orders but they were working on getting that policy changed. I asked if we could call my doctor, she had to be in the hospital by then, and he basically said it was too late. So, I leaned back and I felt the needle go in then I felt the pain that I can only describe as having about a 1000 hornets stinging you in the same spot... times 10! It was over quickly thank goodness. I was crying and shaking by then and literally had to take a minute to get my breath.

It is so hard for me to understand how I can have that kind of reaction and another person can't even feel it and it's even harder for me to understand why someone hasn't come up with a better way to do this!!

hi. I had the sentinal node biopsy done twice. Once in 2006 and then this year on the other side. The first one in 2006 was a complete failure and ended up losing 17 lymph nodes with 0 cancer In Any of them. Back then I don't remember how many shots but it had to of been 4 or 5 and the pain was horrible. I cried and they apologized. It was way worse than anything I had ever experienced. It all failed anyway....they say they waited too long to do the surgery after my injections. So maybe there was dye in there that they don't inject later now after your asleep. Whatever the difference I was thrilled at how well it went. This time they had me rub numbing cream on my nipple and out side of nipple 2 hours before the injections and they put four injections in and no pain. I was so surprised cuz I was sure it would still hurt. But it was fine. And I only lost one lymph node....no cancer. So next week I do my double mastectomy with trams flap reconstruction. The radiologist said that not all doctors recommend the cream and in his experience he has not seen anything different other than the discomfort. He don't get why they all don't just recommend it to everyone...he would be the man to know I suppose cuz we watched the stuff move right along in the picture of my lymph nodes....we had time to wait so he went ahead and showed us what it looked like on camera. This time was a pretty cool experience....except of course the I.v. Part of it...had to use my feet because I have no lymph nodes in one arm and then they were operating in my arm of the other so they went to my feet and had a hard time....I hope my bruises are gone by next Wednesday.

I'm glad this topic came up. This is definitely something I need to ask my surgeon about before it's too late. I had no serious problems with my core needle biopsy. The nurse kept encouraging me to squeeze her hand, but the procedure was just mildly uncomfortable compared to other things I've endured that made me feel like I was going to faint or be sick (at PT with my encapsulated shoulder, for example). I've had Synvisc injections in my knees and know that it is sometimes far more painful than other times, even with the same PA performing the injection. The Synvisc injections are always preceded by a topical anesthetic and lidocaine before the drug proper. Not doing so seems barbaric.

Edited to add, I'm quite sure I recall my surgeon mentioning the blue dye (or was it the 2nd opinion surgeon?). Is that painful as well or just if they inject the tracers?

VLH

The blue dye is also very painful but it is injected after you are under anesthesia so you don't feel it. Most SLNB use both the radioactive tracers and the blue dye. The radioactive tracers are injected hours (in some cases, a day before) the actual biopsy. After the injections, you come back later for what is termed as "mapping" meaning that they map the radioactive tracers and determine which are the sentinel nodes - then you are off to surgery (at least that is how it was explained to me). The radioactive tracers can't be injected under anesthesia because of the down time between the injections and the surgery.

My concern is that the Nuclear Medicine Department doesn't address the pain involved with the radioactive tracer injections despite numerous studies and academic papers written on the subject.

I was given a prescription for the EMLA cream as well as an Ativan for Friday's SLNB, but I don't have a lot if confidence that either is going to address the significant pain involved in this procedure.

Debbi

I had the sentinel node biopsy injection today. The radiologist said he mixed in a small amount of numbing agent in with the gamma ray tracers. The injection was super quick and almost painless. I was bracing myself and almost felt nothing. Thank goodness. After reading this thread, I was more worried about the injection than the surgery. I guess I'm one of the lucky ones.

Eke. Just found out about this procedure today. My bilateral mastectomy is scheduled for Wednesday, 10/4 and the day before I will get the dye injections. I so thought all I had to worry about was the pain of surgery recovery. Now I'm freaking out about this. I want to cry.

yes pain and tightness in the underarm

Wow!  I was given a local before my combined tumor biopsy/SNB, and I never felt that or the biopsy needle.  (how dare they call that thing a needle!  It is a trocar!)  I am with a large city, major university-affiliated cancer center who does lots and lots of research and clinical trials, so I think they would know that it is very safe.  I never felt a thing, and got my very clear results by evening.  The bruising was still evident after 3 weeks, though. 

Here's a tip:

FOR THOSE HAVING LYMPH NODES REMOVED:

Go to:  http://brace4life.wixsite.com/b4life  to get a FREE lymphedema risk bracelet. They could use more than two partners to give away these bracelets, so ask your local cancer center, fire department, or hospital if they'd be interested in participating!  When you have even just a sentinel node removal, you are always going to be vulnerable to lymphedema.  I just had the level one lymph node dissection done, and I'm ordering a pretty medical alert bracelet from Amazon, but it can't go swimming with me, so I want this freebie silicone model to wear in the water.  I like that I can turn it upside down so the lettering doesn't show unless I want it to. 

I always knew that firefighters are heroes, and they just proved it again in Connecticut. 

I just had this done August 23rd with no numbing agent. I was prepared for the worst and had worried about it for two weeks prior, but it turned out for me not as bad as I'd expected. I don't understand the no numbing agent thing either. My comparison is if a guy were going to get 5 shots around his penis I bet he'd get numbed! LOL The first shot was definately the worst, by the 5th I didn't even feel it. I kept thinking before this part of the surgery that I'm not going to have this nipple in two hours, but you want to put me through more pain???

Martha,

I had the same pain and the swelling--what I had is called a seroma, it is a round swelling, a collection of lymph node fluid under the skin. My doc told me the pain is from the seroma pressing on the nerves. She told me to go back to the post-surgery pain med (for me it was Dilaudid) and take it regularly. It did help to dull the pain. The seroma and the pain went away very gradually. My surgery was Aug. 8 and I still have just a little bit of swelling and pain, but the pain does not bother me now.

Hope you are feeling better, but for sure mention this to your surgeon and see what advice he/she may have.

I feel horrible for those of you who had so much pain with the SNB. After reading about it here for weeks ahead of time I was SO nervous to have mine done ( last week.) I can tell you for me it was a total non event. I barely noticed it! Just one shot with lidocaine ( insist on it!) and boom--no pain. Phew. The anticipation was WAY worse than the shot!