Sentinal node biopsy & understanding MRI report
I'm a 34 year old female with 3 young kids recently diagnosed with I believe early stage breast cancer.
I had a biopsy done on the lump, as well as two axillary lymph nodes that appeared swollen during the ultrasound and they were soft during the biopsy. The results came back as IDC of no specific type, provisionally grade II. ER+ PR+ HER2- and ki67 5% and axillary nodes negative. I also had an MRI which measured the lump as 1.4cm and nothing on axillary nodes.
I'm scheduled for a lumpectomy and a sentinal node biopsy. My first question is the sentinal node biopsy required?
My other question is that my MRI report mentions "multiple high T1 signal seen in the ducts seen extending from distal breast to subareolar region. They are starting below and anterior to the mass. They do not show significant enhancement in subtracted images represent inspissited materials probably from recent biopsy." What does this mean?!
Comments
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Hi, I am sorry you are facing this at such a young age. Yes, the sentinel node biopsy is necessary to see if there is any cancer in the lymph nodes. Even though the MRI didn’t show anything in the nodes, the only definitive way to determine what is there is by taking them out and looking. If there is nothing in the sentinel node they will not take any more out.
My guess on your second question is that something is showing up from the biopsy, but that it is not cancer, but that is a total guess on my part. When are you scheduled for your lumpectomy? -
Hi perigrinelady
my lumpectomy is scheduled for 10 days time, but I'm considering delaying it another week or so as I explore a second opinion elsewhere.
I guess the sentinal node confuses me coz I already had axillary node biopsy and that was negative
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Raysal, a biopsy is not definitive. Only surgery can reveal whether your nodes are involved. I was told absolutely no nodal involvement based on numerous scans. Ended up I had micromets in 2. It was very shocking at the time, but here I am 7 years later, doing great and NED.
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So, the sentinel node biopsy is a little different in that they inject a dye to see where the cancer might drain first to the lymph nodes. If that first node is clear, it is likely that the others are clear, as well. They did your first biopsy on suspicious nodes and now they want to check the sentinel just to be sure.
A second opinion is a good idea, but the sooner you have the lumpectomy the sooner they can give you more of a definitive diagnosis and you can get started with treatment. The positives are that your tumor appears small and you are hormone positive. -
The sentinel node biopsy is typically the first in line of defense of your lymphatic system. If it comes up positive then they will check several nodes that follow. The nodes you had biopsied may have been inflammed for other reasons or may just be a bit larger than normal. That would be my guess. good luck
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I would change doctors if they didn't suggest sentinel node biopsy. It's not called sentinel for nothing. Sounds like you have a good doctor
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Hi Pupmom, you had micromets in 2. I am just checking if you had to do chemo and radiation. I had my surgery. They removed one sentinel lump node. I am waiting for my test result. Thanks.
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I think that part of the confusion is the term sentinel node "biopsy" - like they are just doing another biopsy. What they are doing is actually removing the sentinel nodes - sometimes only 1, many times 2,3, or 4 - and sending it/them to pathology. It doesn't mean that the cancer is elsewhere in your body - just that the risk is higher if cancer is found there.
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Hi asianmom,
I did not have chemo because of my low Oncotype DX score of 14. People can have this test run if they have 3 or less positive nodes.
I did have radiation because we chose lumpectomy.
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