SA NM SENTINEL NODE INJECTION

Hi Emin,

I am so sorry you feel alone. It is indeed a difficult time we are currently experiencing. It sounds as though you will be having a nuclear medicine injection which will allow a radio tracer to identify a sentinel node. That node is the first one to receive lymph drainage from your breast, which is why they want to biopsy it. It will be the node with the highest number of cancer cells, if any. This lets your physicians know if there is spread beyond the breast itself. You won't need to prepare for it at all. The injection and dissection of the lymph node is done once you are completely under anesthesia. Even though you will have no awareness, the area is injected with a local anesthetic since it can be painful. They don't want you to wake with pain from the injection or dissection even though it will be a small part of your surgery.

Best of luck next Tuesday. I hope you will have someone with you after your procedure.

Jane

First of all, I know of at least three different tracers. I'll skip the SAVI scout because it sounds like that is not planned for you (it is new and not widely used yet). So I had two tracers. The first was done at the nuclear medicine department, not the operating room, and wasinjection of a radioactive tracer. The second was injection of "the blue dye" that makes your urine turn blue, and that was done while I was already under anesthesia and I knew nothing about it until the blue urine.

So I think your question is about the injection before surgery. It seems that how and when these procedures are done varies quite a bit. I would call the nuclear medicine department at your hospital and see if they can tell you how it is done there. The person who answers the phone won't really know anything and will need to pass you along to a nurse or tech.

For my own lumpectomy, I went to the nuclear medicine department several hours before my surgery. The nurse or tech truthfully told me that women usually come in terrified, but while I would feel a bee sting poke, it was not too bad. Here is the important part: At this hospital they do one injection and it is next to the tumor. I actually could feel the tumor and showed them exactly where it was. I did feel a poke but it was not horrible.

My relative, on the other hand, whom I accompanied on lumpectomy day, went to a different hospital and had a different and terrible experience. At that hospital they inject four places around the areola with no anesthetic and it was barbaric. If we had known we would have insisted that the surgeon schedule her at a different hospital. We got the idea that this place did it that way because it was more convenient for their scheduling.

I hope you are scheduled for the one injection near the tumor. I don't like it when people post horror stories, but in this case it helps you see what you need to find out in order to advocate for yourself. My relatives surgeon had explained none of this to us, and if he had she would have been able to negotiate a different plan. As it was it was a total surprise because I thought the way mine was done would be the way hers was done. I felt like I had let her down or misled her, but of course that was the surgeon.

My injections, tracer not dye, we’re done the day before my bmx. I slathered my nipple area with EMLA as specialK described. I didn’t feel a thing but many do it without any numbing and are not bothered by pain. Others experience bad pain. If I can avoid pain, I do!

Note that numbing cream needs to be applied an hour beforehand, and globbed on in quantity rather than rubbed in. Cover with plastic wrap, not anything absorbent. A prescription is needed for Emla cream (lidocaine-prilocaine).

I'm glad to hear that the EMLA cream works too. I had some lidocaine for my port and I could have used that, but think I'm still real glad it was done under an anesthetic. Just as exbrnxgrl said, just the thought of an injection in or around my nipple was unbearable to me. I had heard stories like those relayed above. I too thought it sounded barbaric and told my surgeon if it couldn't be done under anesthesia, I just might not be able to do it at all. I don't know if I had the radioactive tracer or the blue dye (I think it was the dye), but I never felt a thing since I was under.

Sunshinegal - What an insensitive doctor you had! You are right - jerk!

ThreeTree, for what it's worth, that was the nuclear medicine doc who I only saw that one time for that procedure. Thankfully, all my other docs were far more attuned to my needs and comfort than that guy. Sheesh!

Mine was done when I was under for BMX as well and I have no idea what did they use and how.

Well-done getting information, Emin. So far it sounds like it will be fine, and you will get to confirm with your surgeon on Monday. Emla cream is a common prescription, so it should be readily available.