Can a BS map/mark the sentinel nodes for removal after MX?
I do not want my sentinel nodes removed as matter of course either before or with MX.
I would like for them to be able to be checked if my multifocal DCIS is hiding invasive cancer after the pathology is done after MX.
I read on this forum that there are some breast surgeons who do this. But my BS has no idea what I am talking about.
If your BS knows what this is, can you let me know. I would love to find a BS who will do this for me. Thank you!
Comments
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Yes, this can be done. There are two methods for marking the SN that I know of...one carries a dye and the other a radioactive compound. The dye is blue and lasts 24-36 hours, the radioactive compound stays in your system longer. The point being that this will depend on the speed of the pathology report. If your BS uses dye, and it will clear the system before the path report comes back, it is possible to put a clip at the SN like you had with the stereoscopic biopsy to find the area after the fact.
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Are you asking if there is a way to determine if the sentinel node is cancerous without it being removed? The radioactive compound and dye help the surgeon find the sentinel node so it can be removed for biopsy. I don't know of any procedure that can determine the status of the node without removing it. Hopefully someone else can give you more information about this.
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A SNB marks the node that the cancer first "drains" to. There are many nodes in your lymphatic system and typically there is the initial node that is impacted by drainage from the breast area, which is why the dye or radioactive substance is placed before. It first needs to work and then second the BS can find the node or in some instances "nodes" during surgery. The premise is that if the sentinel node or first node is cancer free, then the ones "behind" it will be too because the cancer goes through/to the sentinel node first.
If you remove a breast then there is no way to do this process...1) there is no breast to inject and track the dye/radioactive isotope 2) if you take the breast without doing a SNB and an invasive cancer is found (like in my situation a microinvasion was found that was not detected on my biopsy that said my 3cm spot was lobular neoplasia, but it was not or rather a small micro measure of it was not) then there is no way to tell which node is the first node that the cancer "drains" to or would move to initially. At this point an entire lypmh node disection of that area would most likely be necessary to truly check if any cancer cell slipped through and left the breast and is now cruising through the lymphatic system.
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Here is a link from the Pink Lotus center in Los Angeles where they have a procedure to mark the SNB during prophy mastectomy. It is essentially the same as a SNB without removal, unless necessary. This procedure has not been widely adopted but perhaps you can convince your BS to try it.
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