Internal mammary lymph nodes found to be positive after surgery?

cacs - your docs can clarify but I wonder if this is residual disease rather than recurrence, particularly in light of how recently your primary cancer was. I'm not sure there would be time for something to have grown that quickly, more likely it was missed initially, and I am sorry it is a situation you find yourself in. I would request another Oncotype on whatever is surgically removed to make sure that you are not dealing with something more aggressive than previously diagnosed - don't assume. What is your reconstruction schedule currently, and are there any thoughts about how it may be impacted by the potential need for radiation?

I'm so sorry you're going through this additional stress and worry now. I'll be sending good thoughts your way this week. I have wondered about internal nodes and why they don't check those for inner quadrant cancers. Mine was kind of at the edge of the breast tissue close to the sternum, so it didn't totally make sense to me that the axillary nodes would be the first place it would spread. Guess I'll be asking questions when I see my doctors tomorrow.

Also, another question is would an internal node affected show up on an MRI? I would think one as big as yours (1.5 cm) would have shown up. This is what my surgeon told me...the MRI would have shown an affected internal node

CACS, I think I have read about this on the board, but can't remember who posted about it or when. Maybe you could do a search here. I know how you feel though. I got a special punch in the gut when two positive nodes were found during surgery, when pre-surgery MRIs, mammograms, and ultrasounds failed to see them.

I am so impressed with how proactive you are being, and how great an advocate for yourself. You listened to your instincts, and your instincts were validated... Way to go! This is a healing attitude and you've got it.

Some on these boards say "don't google" -- but then, how do you know how to advocate for yourself?

Bravo to your strong self advocacy, CACS!

I had “many” internal mammary nodes that were cancerous when I was diagnosed in 2016. I received extra radiation to deal with them. It is difficult to remove them surgically but not impossible. I it is also possible to have ct guided biopsy, which I had.

I also had a “false positive on my contralateral internal mammary node months late. It was enlarged and lighting up on pet. I had a biopsy and that was benign! I’ve been having it monitored and it stays the same size (a bit over a centimeter), but it’s not growing in size. My onc says that nodes can enlarge and even light up on PET for a variety of reasons.

If they are cancerous, you would fall into 3C, which is still curable! Radiation can deal with those nodes very effectively! Ask about proton radiation to specifically target them while sparing the surrounding tissue. I was intitially distraught over it but was assured they can be dealt with successfully

Ugh. Yes. The appointments are constant. I think it's going to be March before I have a week with no appointments, assuming nothing new gets scheduled, which is probably unlikely. All went well. Still discussing which direction to go with hormones. Got started on radiation. Nothing earth shattering. I did ask my MO about the nodes. She said they focus more on where the breast drains and look there first and that it's really unlikely that anything would show up in other nodes if not in the sentinel nodes. From what I have read, I think that happens a little more than she's admitting, but I think she also thought I was worried and wanted to not add to that. She said anything would show up on repeat scans if there were problems, which makes me curious about your MRI.

I hope the biopsy went well and that your wait for answers goes quickly. I'll be hoping for good news, and if that doesn't come through at least a good plan for dealing with whatever shows up.

CAC Ive had a very similar experience. Had bilateral mx, sentinel node positive, 17 axillary nodes negative. Low onco score, the plan was radiation only, then tamoxifen.

Doing my radiation CT planning session, RO notices internal mammaries and another node near my clavicle are enlarged. PET showed these nodes active. Was able to do CT guided biopsy on one near clavicle, it was malignant. Originally staged as 1A, now restaged to 3B. MO says she suspects the internals to be sentinel, because tumor was in inner quadrant. She says not to put too much thought on the stage, it's 3B because it's assumed if it's in the IMLN it has traveled through the axillary to get there, which is not in my case.

I've completed chemo and new PET shows nodes have shrunk and not active. Im finished radiation and just got my first injection of zoladex to suppress ovaries. Have next PET in March. Because we are not removing these nodes, I will have PET every 3 months.

I'm sorry you find yourself in this situation. MO says this is not common, and I could not find much information anywhere.

Just know that whatever your treatment plan is, you can and will get through this. I was crushed when I learned I would be having chemotherapy. Now I'm glad we brought out the big guns, and I have no question that I did everything in my power to fight this

I will be thinking of you and praying for the best possible outcome for you

I am sorry for barging in, but could you edit the title of the thread to say "mammary nodes" instead of "mammary glands" ? As it is, it's very confusing as you are, indeed, talking about lymph nodes not breast tissue. I came to read because the title made me go "wha...? mammary glands still there after surgery? INTERNAL mammary glands?"

This sounds similar to me. My ER was 100% and PR 100%. Underarm nodes did not show disease on any imaging, but I had a weird internal mammary node that lit up. During surgery, they went ahead and removed it and it was positive, along with 2 other underarm nodes. This mammary lymph node was on the opposite side of where the cancerous tumor was, so doctors were stumped.

Needless to say, it took me from a stage I and no chemo to stage III and aggressive chemo! It sucks, but it goes by fast! I started chemo in October and I have only 9 weeks left! Keep your head up! Hope everything works out!

Edited to add: If I hadn't had the MRI that showed the lit up internal node, they would have never thought to remove it, as that is not common to remove the internal mammary nodes. So yes, my cancer may have spread as time went on. So in your case, it may have been there all along, they just didn't think to remove it or had no reason to do so!

I'm so sorry that this was the outcome. I'm glad you finally have answers though. I hope they come back with a plan that feels right to you. Keep us posted.