Sentinel node biopsy question

During my surgery they took the sentinel nodes and had pathology look at them during the surgery to check for metastasis. All clear. But then they sent them out for final pathology...Not all clear! So my surgeon was torn between going back in to take more or not. She recommended I get a second opinion. I ended up not having more surgery, turned down chemo, and am currently doing radiation and anti hormones. You should definitely ask your surgeon. Best of luck to you

Before surgery, they will use a dye to trace the lymphatic system. This will tell them what nodes are the sentinels (where the dye goes to first) and they will remove them during the surgery. Once removed, they will send them to a pathologist for an intraoperative analysis. If this comes back clean, they won't remove more. If one or more come back positive, they could remove a larger chunk of nodes. Note the intraoperative pathology is not as thorough as the one they will do post surgery. For example, with my wife, her sentinel nodes came back clean during surgery, but the post-operative analysis used a special stain that discovered isolated tumor cells.

For us, they determined that since ITC are clinically node negative, they wouldn't remove more nodes. To my understanding that is the usual practice. However, depending on different characteristics of the tumor, and probably also up to your medical team, they sometimes will remove other nodes even if with ITC.

There are a few ways they can do this. For me, I had 3 nodes removed during sentinel node biopsy. A week later I found out that 1 had about 2.1 mm of cancer in it. The others were clear. Going to take the rest out was never mentioned or offered. Instead they radiated the area.