Sentinel node biopsy question for prophylactic BMX

ShimmerGal
ShimmerGal Member Posts: 29
edited February 2018 in Genetic Testing

Reading about lymphedema, and watching my mom go through it after her breast cancer treatment is making me really nervous to let them take out lymph nodes for my prophylactic procedure.... I have found a couple of previous threads on this but they are all several years old.

I am wondering if there is any updated info on the "Pink Lotus" method of injecting the blue dye for sentinel node identification, but not removing any of them until after the pathology has been completed on the removed tissue. At the time of those threads any drawbacks were unclear.

I also read in a couple of threads that there is a possibility of having the dye injected and a clip inserted at the node location so that the surgeon can find it again. Is that commonly offered these days? My surgeon was pretty clear that they would remove at least 3 nodes or more depending on the dye results :(


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  • Beesie
    Beesie Member Posts: 12,240
    edited February 2018

    ShimmerGal, the surgeon works for you. Unless you sign on the dotted line that you agree to the SNB, it can’t be done.

    Have you had an MRI? If all your screening including an MRI suggests that at this time your breasts show no apparent abnormalities, then one option is to take the risk and opt out of having an SNB done. I may be a bit out of date, but last time I read up on it, SNBs were not recommended for those having prophylactic mastectomies, provided they had a clear MRI. I don’t know if that would apply equally for someone having a PBMX because of a genetic mutation but from my reading here, it does appear that ‘no SNB’ might be the norm.

    I this one of the threads you’ve already found?

    Topic: sentinel node biopsy for prophylactic double mastectomy https://community.breastcancer.org/forum/112/topics/829032?page=1#post_4323502

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  • ShimmerGal
    ShimmerGal Member Posts: 29
    edited February 2018

    yes, that is the thread where I first found a mention of the Pink Lotus method. My last MRI was in September but it was an MRI guided biopsy so not completely free of abnormality at that point! but I will ask my surgeon at my next follow up appt if he can order one. I will be due for a 6 month follow up in imaging soon, for a mammogram this time around, not the MRI but maybe they can swap that?

    I was wondering in the years since, if anyone had any issues with the titanium clips, or the dye didn't stay there long enough to be useful after pathology results, or any reasons like that for my surgeon to not be super on board with my request for this less invasive lymph node stuff.

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  • ShimmerGal
    ShimmerGal Member Posts: 29
    edited February 2018

    My BS called back and he is not familiar with these less invasive lymph-node-sparing techniques but he seems open to the idea. I am still trying to find any clinical studies or further info than what's easily google-d so far. I might try to contact Dr Funk I guess but I have no idea if she even has time for that.

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  • ShimmerGal
    ShimmerGal Member Posts: 29
    edited February 2018

    My BS has consulted with others in the clinic and said he will order an MRI for me. What a relief. He doesn't seem to want to inject the dye before the procedure, but I don't think I need to push for that. I'm just relieved that I have a chance to spare some lymph nodes potentially!

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  • Beesie
    Beesie Member Posts: 12,240
    edited February 2018

    Good news! Now let’s hope that the MRI shows no concerns!

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