Why remove a sentinel lymph node that shows no sign of disease?

Posted by pbnew @pbnew, Nov 16, 2022

What would be the purpose of removing a sentinel lymph node that shows no sign of disease?

Interested in more discussions like this? Go to the Breast Cancer Support Group.

@donlynn

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 .

Jump to this post

I just saw your questions and thought I might give you some impute. I had my surgery 57 years ago, so things were a "LITTLE" different then. There was no Chemo, Radiation only if lymph glands were positive, and no Tamoxifin (had not been discovered yet). So following a Radical Mastectomy, I had 1 lymph gland that looked a little large and no Blue Die (not discovered yet or Sentinel Node). Therefore, 14 were removed. As it turned out all 14 were negative for cancer. The part I thought you might want to know, is that it did take 1 year and physical therapy for me to regain the use of my left arm, but I think that was due to the Radical Mastectomy, not the lymph gland removal. I have not had lymph edema, until the last few years, and this has been very minimal. It may also be due to the fact I broke my right shoulder, and needed a shoulder replacement which has created some lymph problems in the right arm. I know 57 years is a long time ago, and Medical matters have become much more advanced. Hope this may give you a little help in making your judgements .
Gina5009

REPLY
@toomanyquestions

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?

Jump to this post

I may be wrong, but it was my understanding that with the SNL, there wasn’t a risk of lymphedema, the risk comes if they have to do additional incisions with removal of all lymph nodes.
???

REPLY

I got lymphedema with just 2 lymph nodes removed during lumpectomy and still dealing with this nasty condition 😡 nothing works for me 😭

REPLY
@leolion811

I got lymphedema with just 2 lymph nodes removed during lumpectomy and still dealing with this nasty condition 😡 nothing works for me 😭

Jump to this post

Prior to surgery, after my guided needle biopsy (that was positive for cancer) I had MRI and PET scan. Both showed 1 suspicious node. Surgery revealed 7 out of 12 positive. I prepared for possible lymphedema, which started about 2 weeks after radiation finished. Cancer doesn’t follow rules. My care team helped me choose best options post op.

REPLY

My lymphedema started during radiation. ( breast lymphedema) everything I have done hasn’t worked. What worked for you?

REPLY
@leolion811

My lymphedema started during radiation. ( breast lymphedema) everything I have done hasn’t worked. What worked for you?

Jump to this post

Start decongestive therapy by therapist who is certified in lymphedema therapy as soon as possible. There is no cure, only management, but results are better the earlier you seek treatment. I wear a compression sleeve and glove. Not thrilled about this, but I order “fancy” printed colorful ones. I am developing edema in my chest and I have an appointment with therapist next week-will most likely need a compression vest. My therapist has taught me lymphatic massage and “dry brushing”-this may help you

REPLY
@leolion811

My lymphedema started during radiation. ( breast lymphedema) everything I have done hasn’t worked. What worked for you?

Jump to this post

@leolion811
Check with your oncologist for referral to Physical Therapist with knowledge of lymphedma. They can work on the lymph veins as well as recommend "swell spots" which help with lymph drainage to get relief. Below is a youtube video of a "chip bag," but I use a "swell spot" and the shape was prescribed by my PT that reaches from the side rib cage, under the armpit, and over throughout the breast. I place that under my compression bra and wear it throughout the day for several days to up to a week or two. It also helps to break up the fibrotic area from radiation. https://www.youtube.com/watch?v=hqqCLy8wJbk

REPLY

I had that surgery recently. They inject a blue dye into the Sentinel Lymph Node and while you're undergoing surgery, they send it to the Laboratory. In the Laboratory they freeze the Lymph Node and slice it up. This shows them if any cancer, however small, is present. In my case it was clear. Quite ingenious really. Back in the day they just removed all the Lymph Nodes until some genius figured this out. Now that they have it does seem rather obvious. We have made strides in cancer treatments. Hopefully more will follow!

REPLY

I'm pretty sure they cannot tell there is no disease without removing it & testing it. Your question confused me. I had 5 lymph nodes removed. All were negative. What hurt the worst was the needle in the nipple before surgery - to inject the dye for the lymph nodes. They seemed surprised - when I told them that it HURT!! I'd like for them to get a needle injection in their nipple!!! 🙂

REPLY
@leolion811

I got lymphedema with just 2 lymph nodes removed during lumpectomy and still dealing with this nasty condition 😡 nothing works for me 😭

Jump to this post

You did not mention which part of your arm is affected, but if it is your hands I highly recommend compression gloves. I had 14 lymph glands removed, and until very recently had no problem with edema. My hands now do swell occasionally and I put compression gloves with the fingers out. They work like a miracle. If I put them on before bed, by morning the swelling is gone. If I wear them during the day the open fingers make it possible for me to do just about everything. They are very inexpensive $15.00. I think I posted a site where you can buy them online. Hope this helps
Gina 5009

REPLY
Please sign in or register to post a reply.