IDC with positive Auxiliary Nodes

Hi Virgo...this is a link from BCO

http://www.breastcancer.org/treatment/surgery/lymp...

Good luck to you

SHEILA

wishing you the best on these upcoming results. They drove us crazy. It does get easier once you have clarity, good or bad, because then you can plan how to fight it and win.

In the words of the late Tom petty, “the waiting is the hardest part.”

Virgo, I had a positive lymph node that showed up on US and was confirmed through a biopsy. I had an axillary lymph node dissection and they removed 13 lymph nodes. I ended up with two positive nodes but one was very small. CT scan was clear. My path report didn't mention sentinel node because all the axillary nodes were removed. Hopefully your chemo will take care of the lymph node

Let's get something straight: there is no such thing as an "auxiliary" node. The proper term is "axillary" nodes, because they are located in the armpit, aka "axilla." Sentinel nodes are usually located in the axilla (less often, the outer reaches of the breast itself). They are called "sentinel" nodes because they're sort of the "sentries" when it comes to breast cancer: if the tumor spreads to the axillary nodes, the sentinels are the first ones to be affected.

They are identified by the injection of either a radioactive isotope (hence the phrase "lit up"), blue dye, or both. If the sentinel nodes are biopsied and found to be clear, then the tumor is "node-negative." If the sentinels were positive for tumor cells, the surgeon goes further, sometimes even down a level or two, until the next closest node(s) test negative. If more than one level of nodes (usually 5 or more nodes) has to be removed for biopsy, it is called an "axillary node dissection."

You should know that before the development of sentinel node biopsy in 1991 (and the use of blue dye beginning in 1994), full axillary node dissection was the norm--whether mastectomy or lumpectomy (at that time not yet prevalent) was done. As recently as the 1970s, before the advent of mammography (and of screening other than breast exam), if a patient found a lump and sought medical attention, she was rushed to the OR and an excisional biopsy (removal of the tumor) was performed under general anesthesia, and a slice of the tumor was frozen to stabilize & preserve it ("frozen section") and sent to the path lab while the patient was still "under." If it came back benign, the incision was sutured and the patient woke up with breast intact (except for where the tumor had been removed). If malignant, a mastectomy was immediately performed--the standard at the time being a "modified radical," or removal of breast and ALL axillary nodes on that side. (A "radical" also removed some of the adjacent & underlying muscle in arm & chest; a "total" was actually a "simple" mastectomy--only the breast was removed, and even that was considered frivolously risky in the era before lumpectomy was developed).

They really didn't know much about breast cancer back then. It was believed that all breast cancers were so aggressive that from the time a lump was found there was literally no time to lose. The usual scenario was that the only way women found out the results of their breast tumor biopsies was when they awoke in the recovery room with breast either intact (but tumor removed) or missing. In the 1980s, patients were given a few days to decide how to proceed after biopsy; and lumpectomy didn't become standard of care until the late 1980s. (Many surgeons refused to treat patients who would not consent to mastectomy). Chemo was also given more routinely, as was aggressive radiation even after mastectomy.

We've come a long way, baby.

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The lymphatic system is the primary line of defense of the immune system (lymphocytes are made in the bone marrow), and the axillary nodes serve the breast & arm. The arm's nodes and lymph channels (adjacent to and exchanging fluid & blood plasma with the capillaries) carry the protein debris of infection and potential infection back to the axillary nodes, which connect to other lymph nodes & channels and the fluid containing the debris eventually gets excreted in urine. (That is, when the nodes are intact and fully-functional).

ChiSandy...thanks for the explanation but I just assumed it was misspelled !