Sentinal node dye injection for multifocal cancers

HereToHelpMyMom · May 2019

Hi everyone,

This is my first post. My mother is 80 and was just DX with IDC in her right breast (1.4cm, ER+/PR+, HER2-).

There is also a second .9cm suspicious mass in the same breast but a different area (multicentric, not multifocal). It was also biopsied, but the biopsy was cut short because my mother was crying and screaming out in pain when the lidocaine failed to work. The Dr said she usually "obtains more samples, but it's probably ok". Of course, this info was not included in her report.

The pathology said the 2nd mass was found to be "benign, rare glandular breast tissue". I feel I cannot trust those results because of the small amount of tissue they tested ( lab report said it was "multiple fragments", and not "cores"). Both masses were listed as BIRADS5 on the ultrasound, so I was shocked that one would be benign. And of course the Dr wrote "pathology is concordant with imaging findings" (for the 2nd mass, that is the opposite of concordant!)

So, my mother opted for a mastectomy which is scheduled in 2 weeks. I just realized that when they do the sentinel node injection the day before, it will be around the area of the confirmed malignant mass. Will the person doing the injection need to be told about the 2nd mass that "on paper" is benign? What if that area has a DIFFERENT sentinel node? Sorry for the long lead up to this question!

I'm new to this, and very appreciative to have this community to ask questions to. Thank you!

Beesie · May 2019

"I just realized that when they do the sentinel node injection the day before, it will be around the area of the confirmed malignant mass."

For my SNBs, the injections were done around my nipple, in the center of my breast, not in the area of the cancer. While both methods are done, I believe that injections around the nipple is the usual way to do it.

Meow13 · May 2019

I hope your mother is ok. It upsets me that she was put through pain and discomfort during the biopsy. I had another suspicious area discovered either during the ultrasound or the MRI my radiologist wanted to take another biopsy but my surgeon said no. He thought it was unnecessary since he was going to do a simple non skin sparing mastectomy. I must say that I was never put through any discomfort during biopsies or surgeries including my DIEP reconstruction. I feel so fortunate when I hear about the ordeal some have endured. Good luck to your Mom!

HereToHelpMyMom · May 2019

Hi Meow13,

After surgery, was your 2nd suspicious area sent to pathology, and was it found to be benign?

Also, did you do a sentinel node biopsy during your mastectomy? Im just concerned if it works for multicentric cancers, since the primary nodes may be in different areas for each of the masses. Thx for responding!

HereToHelpMyMom · May 2019

To Beesie:

I see. My mothers primary tumor is right behind the nipple, so I falsely assumed that was the only reason they would put the dye there. Thanks so much for sharing that info!

Meow13 · May 2019

Hi, after my mastectomy and sentinel node biopsy(at same time) all tissue was analysed in great detail. The suspicious area turned out to be normal and it was found I was multicentric not multifocal. The two tumors and separating tissue was dissected and it was found with 95% confidence the tumors were separate occurrences one ILC and one IDC. No cancer found anywhere else. I kind of remember the dye injection to isolate sentinel node no discomfort at all. I recovered with no issues then 4 months later did the big 10 hour DIEP reconstruction. I don't think your Mom would want that at 80 years old. I was 53, been cancer free on year 8.

Sentinal node dye injection for multifocal cancers

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