Axillary nodes positive after sentinal nodes just micromets

Hi Leesa, your shock and frustration are understandable. However, staging is often changed after surgery as more information becomes available. In my case, I went into the operating room as Ia and was upgraded to IIIa after surgery. Your oncologist will likely recommend chemo that should take care of any remaining cancer.
Best.

My almost 3cm tumor did not show on mammogram even though it was palpable, it did show on both sonogram and MRI, and was consistent in size on both imaging modalities. I also had a positive SNB, but it only showed 20 isolated tumor cells (IST). Both my surgeon and MO, even though both are progressive and not at all reactionary, insisted on ALND surgery due to my tumor being Her2+. I had the same experience as you with much larger cancer in the axilla. There was nothing palpable in the axilla on pre-surgical exam, and the pre-surgical MRI missed seeing this even though the cancer was large enough to be imaged. I was destined for chemo anyway, but there is always the possibility that radiation would not have been recommended due to the very small amount of cancer in the SNB and because I was having mastectomy it was not needed for the breast, and that chemo and targeted therapy would have not eradicated the situation in the axilla. Having a clinically node negative SNB and positive cancer further up in the axilla is unusual, but it does happen in a percentage of us - you are not alone. Take heart that the known cancer has been removed and move forward with systemic treatment - I know you are trying to cope with what seems like bad news at each turn, but you can do this - wishing you the best.

Sorry you are going through this. I was surprised by the presence of cancer cells in a sentinel node despite having a small tumor. Seamlessly catapulted from stage 1A to 2A. It was just over being a micromet (by like 0.2 mm), but the other two nodes were clear. I do wonder sometimes if there are other cancer cells lurking in the nodes (or somewhere else) that we don't know about since my small tumor with it's moderate grade cells felt compelled to go travelling. But it's a risk either way. I guess they just never know and do the best they can within best practice guidelines, and like another poster said, they try to be minimally invasive. I didn't get chemo because of my Mammaprint results, but did get full on radiation to axillary as well as supraclavicular lymph nodes. I'm not thrilled with how my armpit and shoulder feel after having the radiation, but at least I know the area was zapped. And every time I take my tamoxifen I picture it zapping away anything that might have been left behind.

Hope your visit with the oncologist goes well. I always feel better after talking with mine!

I pushed my surgeon for an MRI before we did surgery. He really wanted to do the lumpectomy. MRI showed a second mass 3 cm below the original mass right above the muscle by 3mm. Surgeon said he would have never cut that low so mastectomy scheduled. MRI and PET scan (after that surprise) showed nothing in the nodes and no mets. Surgery done and more suprises. Scattered DCIS throughout the breast along with IDC primary tumor and sentinel node with micromets and axillary node with cancer as well. Now I'm anxiously awaiting for chemo ready to zap any other surprises away.