lymph node biopsy differences?

@meeshodge
Let me see if I can clarify. Sentinel nodes are lymph nodes, they are the first lymph nodes to be affected if cancer spreads. In a sentinel node biopsy, a tracer material is used to help the surgeon find the sentinel nodes during surgery.

This site has a good explanations about sentinel nodes.
https://www.mayoclinic.org/tests-procedures/sentinel-node-biopsy/about/pac-20385264
US (Ultrasound) and MRI are imaging techniques to help identify the nodes or other spots that need to be biopsied.

Are you scheduled for a biobsy?

Thank you Laurie
I am scheduled next week for an US guided lymph node biopsy (2 nodes) on affected breast side. The surgeon did say that when I had my surgery, they would inject a blue dye prior so he could see if anything else was an issue.
To make sure I am understanding correctly, a SN Biopsy is when you have the dye during surgery?

This was what my surgeon said:

"We should get the Right lymph node biopsy US-guided before any surgery you choose. If the low chance that the lymph node is positive, we have to discuss doing chemotherapy first. We are not do any US-guided lymph node biopsy on the Left. The left lymph nodes look ok. But I will do a left surgical lymph node biopsy if you still choose DMX, because in the low chance there is small cancer on the left (based on whatever the MRI finding on the left could be), then we cannot go back and do a surgical lymph node biopsy".
"If DCIS changes to invasive cancer:
-Lumpectomy, then possibly chemotherapy (other tests to do - lymph node biopsy, Oncotype tumor score), then radiation and endocrine
-DMX - then possibly chemotherapy (we do lymph node biopsy right away during mastectomy, Oncotype tumor score), most likely no radiation (depends on lymph node), yes endocrine therapy".

@meeshodge
Yes, I think normally sentinel biobsy / removal is done during surgery as opposed to while having an ultrasound. Or, at least that was my experience. They biopsied a lymph node prior to surgery that tested positive, so surgeon knew the cancer had spread from breast. At time of surgery (lumpectomy), they injected tracer material and removed two sentinel nodes.

Youve been very helpful. I looked back at my Drs notes and this sounds exactly like what his plans are for me. If I chose lumpectomy, it would be dealt with a little differently.

i had a similar procedure using blue dye. It will show up in your urine later so do not be alarmed. Lasts a few hours. Healing wishes sent.

Thank you for that heads up!

Hi @meeshodge
If you dont mind me asking - what is your initial (pre-surgical) diagnosis? I was diagnosed with invasive on the L and was considering BMX but ultimately did a single mastectomy. I was very concerned about removing the R side (where mammo/MRI were clean) without a node biopsy in case they later found a small cancer on the R side also. (Since I knew you cannot do a sentinel node biopsy after the breast is removed.) My surgeons told me they would not do a sentinel node biopsy on the R side b/c all the scans showed nothing there and that even if a small cancer was also found in the R breast post mastectomy that it wouldn't affect my treatment plan since I still needed to get treated for the invasive cancer that was there in the L breast. Interestingly, one surgeon I consulted tho claimed he was still able to do a sentinel biopsy after a mastectomy but didn't explain how it could be done.

My initial dx as of right now is Garde 3 HR+ DCIS in R breast.
The MRI I had done last week showed:
LEFT BREAST-scattered enhancing foci. Unique intensely enhancing 5 mm focus superior posterior.
RIGHT BREAST (original DCIS diagnosis)-multiple scattered enhancing foci. 9 mm enhancing mass central to medial. Enhancement at biopsy clip, extending to overlying skin anteromedially which may represent post biopsy change or residual tumor.
RIGHT AXILLA-appears slightly irregular.

The follow up US done the following day, to confirm findings was:
RIGHT AXILLARY-adenopathy and enhancing focus
RIGHT BREAST-oval, hypoechoic, angulated mass.
RIGHT AXILLA-asymetrical cortical thickening.

0.7 cm mass R breast
1.3 cm nonspecific lymph nodes R axilla

Ah, ok, your doctor's approach makes sense then. In my case, the mammo and MRI both clearly showed problems on the L side but the right side was clean (both breast and axilla). Since your scan shows potential lesions on both breasts, your doctor wants to make sure he/she can check nodes on both sides, which is the right thing to do.