Sentinel Node Biopsy, pain with just one shot?
I found out that the hospital where I'll have my surgery doesn't use lidocaine when they inject the radioactive tracer before my surgery (mastectomy and sentinel node biopsy). They say that since it's only one shot now (instead of multiple), that it even if it hurts, it's only the one shot. And they said that they think it impacts the effectiveness of the shot if the breast is numb. (Research suggests it doesn't.)
Even the surgeon admits that some patients have said that it's the worse, most horrific pain they've ever felt, while others say it's not bad. They haven't figured out why some women react so negatively to the shot, but I don't want to dread that going in.
Any advice?
Comments
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My BS refuses to use any lidocaine with the SNB injections as he says it slows down or disrupts the flow of the dye. Some women have said their injection felt like a minor bee sting; I'll admit that mine was incredibly painful. I think everyone's different. The only saving grace is that it's a short-lived shot - just a few seconds - and even if it hurts, you can get through it. When I had a recurrence this year my surgeon wanted to try a second SNB to avoid a complete node dissection - sometimes it won't work after surgery and radiation - so he gave me two injections instead of one. Yeah, they both hurt. But it was totally worth it to only have to remove 4 nodes, instead of all of them.
Good luck!
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I am having the lymphosintigraphy without numbing too. More comments would be helpful. The nurse told me that she heard it does sting. Is it just one injection or do they stick multiple times? Does it only hurt while they are injecting or as it travels too
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I had no numbing and it was by far the most painful experience of all my BC treatment. Having said that, it does only last for a very short time. I was told it was like a bee sting. More like 1,000 bee stings. I almost jumped off the bed.
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I had the radioactive injection the night before my lumpectomy. It was 4 shots around the nipple. The first and last hurt the worst. Technician was from Maryland and he said there they use numbing cream and I believe lidocaine, the patient waits about an hour for cream to take effect, then the patient is virtually pain free during shots. Here in New York nothing was offered. I found it quite painful:
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EMLA is the topical numbing cream that can be used, but needs to be applied an hour before the injection. It is available by prescription. I used that and my center puts a bit of lidocaine in the injection as well. Not sure why some docs are hesitant to mitigate pain!
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I know everyone is different, but I had mine done 4 days ago and it was not bad at all. My facility does not use any numbing as they say it interferes with how the tracer drains. The technician also told me that the cream only blocks the pain of the needle stick, but not the feeling of the liquid they inject which is what can cause the pain. For me, the heparin shots after surgery hurt worse.
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I had mine done 11/09 and it is not something I'll soon forget. Mine was 3 shots around the nipple, and I think if it had been just one, it wouldn't have been so bad... but after they do that first one, knowing you have two more to go was pretty awful. Good luck all.
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I really appreciate everyone taking the time to share experiences with this. I've talked to my BS and they won't use lidocaine with the tracer because they think it interferes with finding the right sentinel node. They used to do it, but the surgeons kept saying they had trouble finding the correct node, so they stopped.
My BS promised it would only be one shot, and she'll make sure I'm iced before I go back, and she'll give me numbing cream, and it'll be over fast. What helped the most, though, was that she acknowledged that it affects people differently - not very painful for some, extremely painful for others. She didn't try to play it down, or pass it off as some women don't tolerate pain well, or that it's all in our heads. Her admitting that just made me trust her when she said she'd do everything she could to get me through it with as little pain as possible - at least get it done quickly.
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when are you having it done MyJourneys? I am glad that you are finding some comfort in others' experience and trust in your surgeon. I was pretty concerned too but went in trusting that's it would be ok, and that I could do it even if it was painful. And I wish the same for you! Sounds like you are I need good hands. Let us know when you are having it done so we can send loving vibes of support.
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lcantri, thank you - your kind words mean so much to me. I felt like I was getting a virtual hug!
My surgery is on Dec. 5. I'm getting a MX and the sentinel node biopsy on the left side, and a lumpectomy (for some atypical hyperplasia) on the right. I might need a MX on the right if the hyperplasia turns out to be more. (I have lobular cancer - the sneaky kind that spreads in sheets and isn't usually detected easily.)
Thank you for thinking of me and sending vibes of support. It means a lot to me.
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MyJourneys~
It was absolutely horrible. It was injected right into the tumor. Never screamed so loud in my life. Not fair at all.
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I found it very painful. I have had a couple of broken bones, an eye injury that required me to be conscious, alert and unmedicated during removal of a piece of metal, and had such a fast labor that I did not get an epidural until about an hour before my daughter was born, so I am not unfamiliar with pain and deal with it pretty well. I got through a BMX fine with few pain meds. But the SNB sucked. And the doc/hospital I used did provide a lidocaine script that I applied according to instructions prior to the procedure which took place a couple of days prior to my BMX. Did not matter, still hurt like hell. And there is no reason for it. In the thread noted below posters talk about their experiences and various ways to do the SNB. It is yet another thing that does not need to be a shitty experience, but often is because docs just do what they know to do in their own universe of experiences and we simply don't know enough to ask other for options at the time it is done.
https://community.breastcancer.org/forum/91/topics/728862?page=9#post_3713039
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I just feel horrible for everyone having so much pain with this procedure. Mine was done by a Dana Farber BS who, at least as I understand it, is an expert in SNB, and it was all done under general anesthetic while they were doing the lumpectomy. There was no pre surgery injection that I remember, and I am thinking they may have just used dye. I have no idea if the procedure was due in part beceuse my cancer was upper outer quadrent or just down to the surgeon, or why some women get this painful procedure while others get to sleep for the whole thing and feel nothing.
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myJourneys - I am glad you were able to decipher my message, I just reread it and see how autocorrect botched several words. lol It was very much intended to be a virtual hug and I will keep you in mind on Dec 5. If you want to pm me for more personal communication and questions you are welcome to do so.
As I understand it (I researched quite a bit before mine), not all breast centers do the nuclear medicine procedure before surgery. The blue dye done during surgery is not the same.
The nuclear medicine procedure is done a few hours before surgery and works by introducing a radioactive substance that is then viewable by their machine. It shows where your breast drains to first, the first nodes that would, in theory, be where cancer would travel to from your tumor. My technician showed us the scans and It is pretty cool to see the spots where the isotope drains to.
During surgery, they use a Geiger counter to locate these hot spots where the radioactive liquid collected.
They also inject a blue dye during surgery, which dyes the nodes blue.
So they use both to determine where to remove nodes for best chance of catching any that might be involved.
It is interesting how different centers do things differently. I am being treated at a large reputable university medical center and trust that they have the more recent data from relevant studies and equipment to provide the services that effect the best results. They also use 3D mammography as standard screening. So I trust that they know more than I do about what we need to do for me to identify where it may have spread.
I am not intending for this to sound like "my breast center is better than yours" for anyone who did not receive the same care.There are so many quality places to get good care and I believe they all want the best results for each of us. Just trying to help anxious persons waiting and wondering. If you know you are going to be having it done, it is an extra measure they are taking for the best care they can give to ensure the best results for you. That helped me stave off fears.
From the start of my being diagnosed, i have taken great comfort in knowing that breast cancer is so well studied and treatments so successful. We have so much wealth of knowledge and unfortunately so much experience that I feel almost blessed that if I am going to have cancer, at least it is this common cancer where there is so much information and support. This site, for example, has been a huge help.
Love to all who are here.
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My nurse coordinator suggested that I use an ice pack on my breast on the way to have the SNB done, and while waiting there. I didn't feel anything but the pressure. They only do the radioactive stuff - no blue dye. I hope this helps
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MyJourneys:
I was more terrified of the radioactive die for the SNB then I was for my bilateral mastectomy. When I say terrified I mean terrified. I had read things as bad as it felt like acid being poured on your skin. As they wheeled me to nuclear medicine a few hours before surgery I felt like I wanted to get up and run. Well... It was the easiest part of my entire journey so far. Much easier then the core needle biopsy, easier then a routine blood draw and as easy as mammogram. Seriously! I laughed with the radiologist when he told me he had already done one side. I had it done on both sides and only felt a small pinch on one side. Please try not to stress. You can do this! You are in my thoughts
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Thank you, everyone. I hope I get to be in the "barely felt it" camp rather than the "horrific pain" camp. Either way, it'll be over with next Monday. I'll report back and let everyone know how it goes.
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lizzysmom, I also had everthing done while I was under anesthesia for my lumpectomy. I can't imagine it any other way. It makes me so mad that most women have to go through this without sedation.
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I also had only the blue dye injected while I was under GA. I had been going back & forth between UCLA surgeon and BC-only specialist. UCLA had signed me up for the radioactive stuff w/o talking to me about it; 2 other BC surgeons didn't think the radioactive was necessary for me - I assume since I was DCIS with negative-seeming US and MRI for lymph node involvement.
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I didn't know about the sentinel node biopsy shot until the day of. I was told it was going to be really really painful and that if I wanted to it was OK to swear :-). I thought yeah sure, should be fine, but OMG it really does hurt. I think that was possible the most painful part of my journey.
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Hi everyone, surgery went very well this morning, and I didn't spend the night. I'll share more details tomorrow, but wanted to tell you that the radioactive tracer for my sentinel node biopsy was literally nothing. Didn't even feel a pinch. The tracer went to only one node, so that's all they took. They inserted a wire in my other breast for my lumpectomy there, and that went well, too. Will post more tomorrow
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So glad it went well.
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yes, I am glad it went well. I was thinking about you
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Adding FWIW...I felt like MO221...dreaded the radioactive tracer more than the UMX itself after reading how painful the injection is. I literally felt nothing. The nurse who administered it told me that 8mos ago our hospital changed the type of dye that's used, that it's more "breast specific" and that they've had far fewer complaints since switching. Before, she said some women would complain of it feeling like a bee sting while others were left in tears. Not sure what they use now, but I'm thankful that they're having better pain-free results! That was certainly my case!
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Hi everyone,
I thought it was important to update this thread due to my experience with my 2nd sentinel node biopsy and the tracer injection. After the pathology came back as triple negative ILC on the lumpectomy, they did a SNB on my right. When they previously injected the radioactive tracer on my left side, I didn't even feel the needle go in, and didn't feel the tracer at all. When they did the second one on my right side, I felt everything - the needle, the tracer, everything. It's "hold-on-the-table-and-try-not-to-cuss" painful.
The first doctor said, "you won't feel this." And I didn't.
The second doctor said, "this will hurt." And it did. She said she couldn't believe the first one didn't hurt.
I have no idea why I had two different reactions to the same procedure, and the fact that both doctors had such different experiences giving the tracer is just odd to me.
Although no one here has accused the women who say the pain is horrific as being intolerant of pain - I'd like to confirm that it's absolutely not that. I delivered four children naturally with no pain meds. One shot was nothing. The other shot was extremely painful, but short-lived. Same woman, two breasts, two different experiences.
More research needs to be done to lessen pain for women who go through this. We go through enough.
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