Expectations for Sentinel Node Injection

Hi gals, I had a radioactive seed implanted before my lumpectomy for invasive ductal carcinoma, and the deadening shot stung a bit but I didn’t feel the seed part.
And it was a bit close to the nipple.

@anjalima what does it mean 5 layers of nodes removal?

If I said 5 layers, I misspoke. I had one known positive sentinel node (through biopsy). At the time of unilateral mastectomy another sentinel node looked positive… and it was (micro infiltrated). So, my surgeons removed the “ next in line” layer of nodes , 5 , which were negative. Those 5 nodes would have been the “next in line” to become infiltrated with the cancer. The fact that they were negative was a very good diagnostic indication that distant metastasis had not occurred. This is my understanding.

Hope this helps.

By “sentinel node injection” I’m thinking it’s a needle biopsy followed by another injection to insert a “clip” with which the surgeon will identify the biopsied node at the time of surgery.

There is also a nipple injection of radioactive dye , day before surgery, which helps the surgeon locate the travel path of cancer cells into the nodal system associated with the breast.

Hope this helps.

Thank you. My surgeon shared if she finds just 1 sentinel node positive, she will remove the whole group of axillary nodes. It looks like you found 2 sentinel nodes positive, but they removed 5 axillary nodes. I am confused. 🙁

@anjalima did you get lymphedema?

I did not. My understanding is that it could appear in the future but I’m feeling confident that I’m ok 7 mos later. I did not have radiation which “ could” up the percentages a bit. My exchange surgery was in July and my only treatment going forward is ( anti ) hormone meds aka AI … aromatase inhibitor. It interferes with the conversion of estradiol and progesterone INTO estrogen. My diagnosis was 99% estrogen positive!

Keep your eye on the prize… clearing cancer from the breast and any affected nodes. It’s a bewildering amount of information to digest and decisions to make.

Happy to answer any questions to the best of my ability. That said I am not a medical professional so check any information out with health team as everyone has a unique set of variables .

Best to you 🌸

Ask what “ whole group” means. Ask if a radioactive injection ( into nipple) day before surgery can help locate the path . They must remove more than the sentinel nodes if positive. They remove up to a clear margin of nodes so to speak. For me that was 5 other.

Whole group of axillary nodes which is 20- 40 axillary nodes. Every human is very unique. I don't know many I have.

She is going to remove sentinel nodes first 1 - 3. If she will find a sentinel node positive, she wants to remove 20 - 40 axillary nodes.

I am confused in your case. You removed to positive sentinel nodes and another 5 axillary ones. Why they didn't move the whole group of sentinel nodes and axillary nodes?

You're asking the right questions, Poliana. Traditionally, when a sentinel node is positive, surgery to remove all the underarm lymph nodes (20-40) is done. This is called an axillary node dissection and is done to reduce the chance of recurrence.

A trial called AMAROS published in 2013 found women diagnosed with early-stage breast cancer with a positive sentinel node are less likely to have lymphedema if they get radiation to their axillary lymph nodes instead of having them surgically removed. These results also showed axillary lymph node radiation reduces recurrence risk about the same amount as axillary lymph node surgery.
Read more here: https://www.breastcancer.org/research-news/outcome-same-for-early-bc-tx-w-node-rx-or-sx

Long-term results from another large clinical trial (https://pubmed.ncbi.nlm.nih.gov/28898379/) confirm that, for some women with early-stage breast cancer who have lumpectomy as their surgical treatment, a less extensive lymph node biopsy approach is sufficient.
Read more here: https://www.cancer.gov/news-events/cancer-currents-blog/2017/breast-cancer-lymph-node-removal

I recommend talking to your doctor about these various options and which is best for you.