Expectations for Sentinel Node Injection

My breast surgeon did not think it was necessary. You may have a unique circumstance about which I cannot comment. That said, I would, and did, seek a second opinion.

Is there a major cancer center near you?

Mayo Clinic, memorial Sloan Kettering, John’s Hopkins, Dana Farber etc. these kinds of hospital programs for breast cancer would be a good place to seek more information.

Hope this helps. 🌸

I am going to meet Dr. Alexandra H. on October 13th, at Sloan Kettering.

The injection is a dye. It is typically done by radiology. It is injected around the tumor. During surgery the can see where that area is draining and what lymph nodes it is going to. They will take that/those nodes and send them to pathology to determine if the cancer has spread to the lymph nodes.

Correct, the purpose of the dye is to identify the lymph node where the breast would 'drain to' in the event cancer cells infiltrated into the lymphatic system. The first node likely to be reached is usually (buy not always) also the closest node. The dye helps identify the actual 'first node ("sentinel") wherever it actually is. I strongly resisted the idea of having it done but changed my mind at the last minute. That node-negative biopsy was very valuable information that I almost didn't have...

And doesn’t this all happen while I’m still on the table as then they may take the next layer of nodes if they detect signs of cancer in sentinel nodes?

It really can’t as it has to be sent to pathology to determine if the cancer has spread to those nodes. That takes time! I know this because I asked my surgeon! I wish they could do it all during one surgery but apparently not possible!

I agree. If it is negative it will relieve a lot of worry and anxiety! If it is positive, they will know to treat it with another surgery or with radiation or both!

Correct. I asked my surgeon a similar question and she noted that biopsies take time. If I remember correctly, I got the biopsy results of both lumpectomy and sentinel node about a week later. An anxious week later, I might add...

I had the radioactive dye injection ( two actually as I had two known tumors) day before my unilateral mastectomy. My surgeons then used a pen sized Geiger counter ( so to speak) to trace the flow from tumor to nodal system. One sentinel node was known positive through a previous biopsy, a second looked suspicious at surgery ( and was positive) and then the next layer ( in the nodal flow pattern) of 5 axillary nodes were removed … all of those were negative!

The value of the injection is that it allows the surgeon to trace the path and remove any suspicious nodes along that path up to a clean layer ( so to speak). So they do need to remove more than what is immediately obvious.

The injections were brutal but very quick but have given me an abundance of relief to know that my next layer above the positive nodes was clean! I think of it as clean nodal margin.

I presented my forms at the desk of nuclear medicine at 8 am. By 8:30, the technician was injecting 4 needles around my melanoma site, on my arm. I was wheeled to surgery , with results in hand, for a 10:30 survey. By 10:45 , I was under and I was released by 1 pm.
Tne majority of time, in nuclear medicine, was waiting for the dye to move through the lymph system.
I expect that this would vary, depending on the site.