I just had four sentinel nodes removed on Monday during my unilateral mastectomy. They look clean on MRI and in general, but the biopsy will confirm it.
Colleen Young, Connect Director | @colleenyoung | Nov 19, 2022
@pbnew, can you give a bit more background to your question? I know that you are no stranger to breast cancer and treatments as a patient living with with metastatic breast cancer. Has something changed and your oncology team is recommending further investigation by removing a sentinal lymph node?
@pbnew, can you give a bit more background to your question? I know that you are no stranger to breast cancer and treatments as a patient living with with metastatic breast cancer. Has something changed and your oncology team is recommending further investigation by removing a sentinal lymph node?
Thanks for clarifying. @lisakinpa's response explains well. In short the sentinel lymph node is removed and analyzed to see if cancer has spread beyond the tumor. The sentinel lymph node would be the first place that cancer cells may spread to.
"Sentinel node biopsy is a surgical procedure used to determine whether cancer has spread beyond a primary tumor into your lymphatic system. It's used most commonly in evaluating breast cancer and melanoma.
The sentinel nodes are the first few lymph nodes into which a tumor drains. Sentinel node biopsy involves injecting a tracer material that helps the surgeon locate the sentinel nodes during surgery. The sentinel nodes are removed and analyzed in a laboratory.
If the sentinel nodes are free of cancer, then cancer is unlikely to have spread, and removing additional lymph nodes is unnecessary.
If a sentinel lymph node biopsy reveals cancer, your doctor might recommend removing more lymph nodes."
I am reading recent studies that question whether sentinel node biopsies are necessary before mastectomy for DCIS. , Especially if the DCIS is only visible on MRI, has no palpable mass, and in women over 60.
The possibility of lymphedema seems to be causing doctors to question whether SNB is needed. If invasive cancer is found post-mastectomy, would the sentinel node provide any important information we couldn’t find out using the removed breast tissue? Are micro-invasive cells too easy to miss when looking at whole breast removed tissue?
Thanks for clarifying. @lisakinpa's response explains well. In short the sentinel lymph node is removed and analyzed to see if cancer has spread beyond the tumor. The sentinel lymph node would be the first place that cancer cells may spread to.
"Sentinel node biopsy is a surgical procedure used to determine whether cancer has spread beyond a primary tumor into your lymphatic system. It's used most commonly in evaluating breast cancer and melanoma.
The sentinel nodes are the first few lymph nodes into which a tumor drains. Sentinel node biopsy involves injecting a tracer material that helps the surgeon locate the sentinel nodes during surgery. The sentinel nodes are removed and analyzed in a laboratory.
If the sentinel nodes are free of cancer, then cancer is unlikely to have spread, and removing additional lymph nodes is unnecessary.
If a sentinel lymph node biopsy reveals cancer, your doctor might recommend removing more lymph nodes."
My nodes were clear on ultrasound before surgery. During lumpectomy for Estrogen and HER2 positive, my Oncoplastic surgeon removed 2 sentinel nodes. The pathology report after surgery showed microscopic cells in each . I asked surgeon if I needed another surgery to remove more nodes .. she said she doesn’t believe in removing too many due to the long term side effects . Chemo and Radiation will take care of the other nodes. I don’t know if I should seek a second opinion .
I was wondering but didn’t ask in this community—there were a few posts that said the MRI showed that their sentinel nodes were clear. That confused me because I had an MRI and my report never mentioned the sentinel nodes so I figured it’s water under the bridge at this point. I never knew if/that the MRI could give results about lymph nodes but it’s water under the bridge…My cancer was bilateral, DCIS on 1 side and a micro invasion on the other, so double mastectomy. The afternoon before surgery, the surgeon put in the contrasting dye with the obvious intention of checking lymph nodes. She found the sentinel node on the DCIS side and removed 2 more. They were all negative. She thought she found the sentinel node on the micro invasion side but removed 7. Labs showed no sentinel node (I was not told how they can tell the difference) but all 7 nodes were negative. Testing on the tumors showed that I did not need chemo. I did have lymphatic cording but PT helped.
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I believe your surgeon would have to remove the sentinel lymph node so that pathology can dissect the node to ensure there are no cancerous cells.
Lymph nodes are tiny and probably not as large as we imagine. Our surgeons use blue dye to act as a tracer to help locate them because they’re small.
If the sentinel lymph node which is the node closest to the tumor, does contain cancerous cells, your surgeon may then proceed and take a few more. ♥️
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2 ReactionsI just had four sentinel nodes removed on Monday during my unilateral mastectomy. They look clean on MRI and in general, but the biopsy will confirm it.
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5 Reactions@pbnew, can you give a bit more background to your question? I know that you are no stranger to breast cancer and treatments as a patient living with with metastatic breast cancer. Has something changed and your oncology team is recommending further investigation by removing a sentinal lymph node?
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1 ReactionI’m asking the question for my daughter. I don’t have cancer anymore.
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2 ReactionsThanks for clarifying. @lisakinpa's response explains well. In short the sentinel lymph node is removed and analyzed to see if cancer has spread beyond the tumor. The sentinel lymph node would be the first place that cancer cells may spread to.
Here's more information from Mayo Clinic:
- Sentinel node biopsy https://www.mayoclinic.org/tests-procedures/sentinel-node-biopsy/about/pac-20385264
"Sentinel node biopsy is a surgical procedure used to determine whether cancer has spread beyond a primary tumor into your lymphatic system. It's used most commonly in evaluating breast cancer and melanoma.
The sentinel nodes are the first few lymph nodes into which a tumor drains. Sentinel node biopsy involves injecting a tracer material that helps the surgeon locate the sentinel nodes during surgery. The sentinel nodes are removed and analyzed in a laboratory.
If the sentinel nodes are free of cancer, then cancer is unlikely to have spread, and removing additional lymph nodes is unnecessary.
If a sentinel lymph node biopsy reveals cancer, your doctor might recommend removing more lymph nodes."
-
Like -
Helpful -
Hug
6 ReactionsI am reading recent studies that question whether sentinel node biopsies are necessary before mastectomy for DCIS. , Especially if the DCIS is only visible on MRI, has no palpable mass, and in women over 60.
The possibility of lymphedema seems to be causing doctors to question whether SNB is needed. If invasive cancer is found post-mastectomy, would the sentinel node provide any important information we couldn’t find out using the removed breast tissue? Are micro-invasive cells too easy to miss when looking at whole breast removed tissue?
-
Like -
Helpful -
Hug
3 ReactionsMy nodes were clear on ultrasound before surgery. During lumpectomy for Estrogen and HER2 positive, my Oncoplastic surgeon removed 2 sentinel nodes. The pathology report after surgery showed microscopic cells in each . I asked surgeon if I needed another surgery to remove more nodes .. she said she doesn’t believe in removing too many due to the long term side effects . Chemo and Radiation will take care of the other nodes. I don’t know if I should seek a second opinion .
-
Like -
Helpful -
Hug
1 ReactionMy sentinel nodes are negative. They removed 6 not 4.
I Hope more people respond to this question. I am really nervous about missing something.
I was wondering but didn’t ask in this community—there were a few posts that said the MRI showed that their sentinel nodes were clear. That confused me because I had an MRI and my report never mentioned the sentinel nodes so I figured it’s water under the bridge at this point. I never knew if/that the MRI could give results about lymph nodes but it’s water under the bridge…My cancer was bilateral, DCIS on 1 side and a micro invasion on the other, so double mastectomy. The afternoon before surgery, the surgeon put in the contrasting dye with the obvious intention of checking lymph nodes. She found the sentinel node on the DCIS side and removed 2 more. They were all negative. She thought she found the sentinel node on the micro invasion side but removed 7. Labs showed no sentinel node (I was not told how they can tell the difference) but all 7 nodes were negative. Testing on the tumors showed that I did not need chemo. I did have lymphatic cording but PT helped.