Lymph Node Removal with Stage 3A

Hi!

I was diagnosed at Stage IIIA, with one node compromised. I ended up having Axillary Lymph Node Dissection (ALND), which meant that the surgeon took out all of my Levels I and II lymph nodes, or 20 in all. (The surgeon did not take out my Level III nodes.) I have not developed lymphadema (so far).

Sentinel nodes are removed in BC patients to see whether or not their nodes are involved. How do you know you have nodes involved? My node was picked up on a scan and my radiologist did a fine-needle biopsy to confirm it was cancer. I think one of the problems with selective node removal is that scans can be inaccurate about the number of lymph nodes involved. I have heard, however, of some BC patients getting selective node removal and then getting radiation in the armpit area. That might be a possibility. Definitely talk about this issue with Surgeon #2. Best wishes!

I originally had three nodes removed with BMX (SNB). All showed clean. When I had a recurrence, it was in a lymph node under my collar bone. I had chemo both before and after this second surgery and also had radiation. It was only the one node that was malignant, so the surgeon only removed 7 nodes doing an ALND.

Good luck with your second opinion.

carboplatin is actually not a new drug. When people talk about TCHP or TCH, they are referring to Taxotere, Carboplatin, Herceptin & Perjeta. When they talk about AC, that's adriamycin and cytoxan.

I had both, so yes I had carboplatin. However I didn't have a complete response so that's why I had AC after surgery.

Xeloda had a study done on it a few years ago called Create X. It provided results that it keeps a potential reoccurrence away better than not using for those of us that did not have a huge response to neoadjuvant chemo. Since my tumor barely changed size and originally was up on my chest wall.....for me it made sense to do it. There are several threads on Xeloda and TNBC if you are interested in reading more!

- HarleyDream

My Breast surgeon only took out the first layer of lymph nodes to reduce the risk of L.E. I knew from my 2nd biopsy after MRI that I had lymph node involve

Because of my stage & tumor size, my surgeon wanted chemo first, but my MO wanted surgery first so she could base my treatment on the pathology. They agreed (finally, as I sat in one office as they texted each other about it!) that step 1 would be SNB, followed by chemo, followed by BMX. After the SNB, my BS told me she was able to locate the sentinel node, but could clearly see that a few others nearby were positive, so she removed them - a total of 8, leaving my risk of LE relatively small.

Based on the positive nodes & follow-up PET, I completed my chemo, surgery and rads. At the time of my BMX, I was concerned they'd do an ALND, but my surgeon said no, she wouldn't check anymore and wouldn't remove anymore, because rads would effectively treat any possible residual cells.

I'm 5 years out, still on AIs but living pretty much side-effect free (and boob-free as I chose not to reconstruct). I take precautions on my SNB side (no draws, bp, heavy lifting, etc.) just in case it helps keep LE away, and so far, so good!

Good luck, Hanging_in_there!

Hi there - you definitely never know. I had 4 nodes removed during the sentinel node biopsy, all four had cancer. they weren't expecting to find any. Once I completed chemo and had a re-excision and ALND, they removed another 8 (I think?) and three had what they called "treatment effect" - scarring from chemo doing its job. So there were at least another three nodes that were affected.

It has only been a year, I am active, have had some swelling here and there, it's mostly the tightness in my chest and the muscles under the arm that bother me. I wear a sleeve occasionally. It's not bad swelling it's more of peace of mind, I suppose. But it hasn't even been a year, so I'm giving it time. Physical therapy and yoga has helped a ton.