Why so many nodes removed?!?!

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Anonymous
Anonymous Member Posts: 1,376
edited August 2019 in Surgery - Before, During, and After

About six weeks ago, my sister (triple negative, BRCA1 gene mutation) had a double mastectomy and a prophylactic bilateral salpingo-oophorectomy. She had cancer in just one breast however she was only informed yesterday that they took out seven nodes on one side and three nodes on the other.

What are some of the reasons they take so many nodes, especially when cancer was only in one breast?

Thank you.

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  • HopeWins
    HopeWins Member Posts: 181
    edited August 2019

    My BS explained that some women have 1 and some women have 3 or 4 sentinel nodes. He'll take however many I have. That said he's not planning to take nodes from my prophylactic side.

    Did your sister discuss this with the BS prior to surgery? Maybe he saw something in the prophylactic side that seemed suspicious? I know I'm having the tracer fluid injected into my nipple before surgery. Do you know if she did and both breasts were injected?

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  • Beesie
    Beesie Member Posts: 12,240
    edited August 2019

    Although it can't be known until surgery how many nodes will have to be removed during a Sentinel Node Biopsy, 7 seems like a lot. Usually it's 2-3. It's all a question of how many nodes the dye and/or isotopes (from the pre-surgery injections) move into - any nodes that the dye/isotopes enter need to be removed and checked under a microscope. If the injected fluid travelled to those nodes that quickly, then those are the nodes that cancer cells were most likely to travel to, if any cancer cells had entered the lymphatic system. Did you sister sign off on only an SNB for cancer side or did she authorize the removal of more? Was any cancer found in any nodes, which might have led to the removal of more nodes?

    As for the prophylactic side, an SNB would only be done if your sister signed off on it. It's debatable whether nodes should be checked when a MX is prophylactic. Whether it's recommended seems to depend on the individual surgeon but ultimately the patient has the final say because the surgeon can only do what the patients signs up for.

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  • Beesy_The_Other_One
    Beesy_The_Other_One Member Posts: 274
    edited August 2019

    Did they tell your sister before yesterday that they'd removed nodes from both sides (just not how many)? Considering the possibility of lymphedema, she needed to have known that before now, for blood pressure cuff purposes alone! My friend who had a UMX right before me had seven sentinel nodes. I had only one. When I inquired about the number of nodes we have, my breast surgeon said it varies widely and they really don't understand why.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited August 2019

    I'll have to double check whether or not the doctor discussed the removal of nodes prior to surgery. I think she became overwhelmed because, following chemo, the doctors switched and told her that she needed the mastectomy, etc. For months she had been told she would need a second re-excision lumpectomy in the right breast. I know she switched surgeons because she lost confidence in the first one who, she said, was always in a rush and preoccupied.

    My sister never heard of lymphedema from her doctors prior to the discussion about it yesterday. I had mentioned it to her months ago after I was sent to a lymphedema specialist for education by my radiation oncologist.

    I appreciate those who have responded to my question! I don't have answers to questions you've asked at this time, but I plan to digest what you've shared and discuss with my sister.

    We live 3000 miles apart; and she's very busy this season with work, so our discussions are often sporadic. As an aside, my sister who is 70 years old did remarkably well through ALL her surgeries and chemo!

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited August 2019

    My sister discussed node removal before her surgery but no one told her until just that other day that they took so many. Maybe it was in a pathology report but most lay people find it difficult to decipher the jargon!

    I can't understand why it took them so long to talk to her about lymphedema related issues. She's had doctor appointments for other health issues; what if someone took blood pressure or a blood draw from either of her arms?

    My sister is very busy with work now so it's going to be some time before we can discuss these things without interruption.

    Thanks again for everyone's feedback!

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