Radioactive blue dye injected to the breast for lymph node dissection

Posted by Glori @elvandi, Apr 25, 2017

Has anyone had this radioactive dye injected tracer before surgery to see if cancer in the lymph nodes. I understand it is very painful and since I was told this would be done for me before I have the lumpectomy removed in my breast. I, want to know more about it. Hope someone can advise me.

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@jcolby

After lumpectomy (20mm, grade 3) I only had radiation. By the way 3mm is about 1/10 of an inch. Did you mean 30mm?

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Christinemd - Did you , also, have Chemo before the radiation ? I am 74 and had total Mastectomy and will follow up with Chemo only and then Hormonal treatment for 5 years..
Cancer comes in the later years of a women's life. runninglakes

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@jcolby

I was offered chemo, but my oncotype dx was only 27, and factoring in my age (70), i didn't think the very small risk reduction was worth it. So i declined chemo. And my surgeon and oncologists said that studies showed equal outcomes of lumpectomy with radiation, versus mastectomy and chemo. So i chose lumpectomy and radiation. I was ER/PR +, HER2 -. During surgery, the tumor was sent to pathology, surgeon was immediately notified margins were not clear, so he took more, and then the margins were only .5mm. Small but clear nonetheless. So only one surgery. Fabulous surgeon! Now on anastrozole, but switching to letrozole.

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If you have Left breast cancer, then I would check Proton Radiation - which does not hit the heart or lungs. Only certain clinics do this.
runninglakes

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@jcolby

I was offered chemo, but my oncotype dx was only 27, and factoring in my age (70), i didn't think the very small risk reduction was worth it. So i declined chemo. And my surgeon and oncologists said that studies showed equal outcomes of lumpectomy with radiation, versus mastectomy and chemo. So i chose lumpectomy and radiation. I was ER/PR +, HER2 -. During surgery, the tumor was sent to pathology, surgeon was immediately notified margins were not clear, so he took more, and then the margins were only .5mm. Small but clear nonetheless. So only one surgery. Fabulous surgeon! Now on anastrozole, but switching to letrozole.

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If you have Left breast cancer, then you can check on Proton Radiation which does not hit the heart and lungs. Only some clinic/hospitals provide this.
runninglaes

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I did not have to do chemo.

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@cathymz3

I've been diagnosed with Stage 1 breast cancer. Need to have a lumpectomy to remove the tumor and some breast tissue. During surgery can someone tell me their experience?. For example: how do you handle the anesthesia and also if you needed a epidural? I'm concern as to why an epidural would be needed?

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Thank you for your nice words of wisdom and kindness.

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@elvandi

Cathy, you will be fine. The Lumpectomy is very easy, no pain, the anesthesia goes very smooth, you can request a pill beforehand to prevent nauseous and the injection for radioactive dye to locate and check lymph nodes does not hurt, it is acceptable if you just relax. You will go to sleep easily and wake when it is over and would feel a thing. I had it 2 times. Any questions you must ask, also, your doctor and understand everything. Just RELAX . runninglakes

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I should have had your doctor for the blue dye injection. For me, it was the worst pain I've experienced. Including labor!

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I'm 72 & I had cancer in my left breast (6cm) and some type of non-cancerous lump in the right one, so I chose to have a double mastectomy with reconstruction. I had blue dye injected in my breast before my surgery so that the surgeon was able to find the sentinel lymph nodes. It was injected in several small vials in various places above the nipple. It was not intolerably painful. (But, I can imagine how painful it must have been to have it injected in your nipple!). When I came out of surgery, my left breast had a huge black spot at the intersection of the horizontal and vertical cuts. Apparently, I had a reaction to the dark blue dye, because it caused the skin to die and peel or flake off, leaving raw open skin underneath. Also, fluid was weeping out between the stitches even though there was a drain inserted in my breast. The area where the blue dye peeled off became infected and I spent nearly a month trying to clear it up with Cephalexin and then later a round of Bactrim. The Plastic surgeon cut out the infected area, but it was all the way down to the expander she had inserted and wouldn't heal. So, I had to have another surgery to have the expander removed. When I saw how she sewed it back together, my heart fell. It looked like something from a Frankenstein movie. I don't think they will ever be able to do breast reconstruction on it anymore. The Infectious Disease doctor called me and said that she saw on the lab report that there was a Pseudomonas infection and the Bactrim the Plastic Surgeon was giving me would not work on that. So she switched me to Cipro. I sure hope that finally takes care of it. I will need to take anti-Estrogen meds for the next 10 years, and the oncologist said that I will have to have radiation, but not chemo. The plastic surgeon said she doesn't want to do expanders or inserts after radiation therapy because the skin becomes damaged from it. But, I can't keep waiting for months to have radiation. I also need another surgery due to a fistula on my colon and could end up with a colostomy; but, they won't do that until I recover from the breast surgery. Once the breast heals up, I need to start radiation therapy every day for 6 weeks. Sometimes, I wonder if I'll ever recover all this. Its been very disheartening! When I check the surgery report, it said that they injected Lymphoseek, which is a radioactive solution designed to identify the lymph nodes that drain from a primary tumor. But this is a clear solution and not dark blue. There was no blue dye on my right breast, so they must have just added it to the left breast when they did the injection, since that was the one that had cancer. I don't know how it got all over the outside of my skin.
Glori, f you are going have dye injected for the purpose of finding the lymph nodes, I suggest you get tested ahead of time to see if you have a reaction to it. It's rare, not fun if you do. You could ask them to just use Lymphoseek to find them without the blue dye. I read that the dye is only very slightly more accurate in finding the lymph nodes. If you do decide to have the blue dye, be aware that your urine will be green for several days afterward. I wouldn't worry about the pain. I hope you have a much better outcome than I did.

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@alexisq

I'm 72 & I had cancer in my left breast (6cm) and some type of non-cancerous lump in the right one, so I chose to have a double mastectomy with reconstruction. I had blue dye injected in my breast before my surgery so that the surgeon was able to find the sentinel lymph nodes. It was injected in several small vials in various places above the nipple. It was not intolerably painful. (But, I can imagine how painful it must have been to have it injected in your nipple!). When I came out of surgery, my left breast had a huge black spot at the intersection of the horizontal and vertical cuts. Apparently, I had a reaction to the dark blue dye, because it caused the skin to die and peel or flake off, leaving raw open skin underneath. Also, fluid was weeping out between the stitches even though there was a drain inserted in my breast. The area where the blue dye peeled off became infected and I spent nearly a month trying to clear it up with Cephalexin and then later a round of Bactrim. The Plastic surgeon cut out the infected area, but it was all the way down to the expander she had inserted and wouldn't heal. So, I had to have another surgery to have the expander removed. When I saw how she sewed it back together, my heart fell. It looked like something from a Frankenstein movie. I don't think they will ever be able to do breast reconstruction on it anymore. The Infectious Disease doctor called me and said that she saw on the lab report that there was a Pseudomonas infection and the Bactrim the Plastic Surgeon was giving me would not work on that. So she switched me to Cipro. I sure hope that finally takes care of it. I will need to take anti-Estrogen meds for the next 10 years, and the oncologist said that I will have to have radiation, but not chemo. The plastic surgeon said she doesn't want to do expanders or inserts after radiation therapy because the skin becomes damaged from it. But, I can't keep waiting for months to have radiation. I also need another surgery due to a fistula on my colon and could end up with a colostomy; but, they won't do that until I recover from the breast surgery. Once the breast heals up, I need to start radiation therapy every day for 6 weeks. Sometimes, I wonder if I'll ever recover all this. Its been very disheartening! When I check the surgery report, it said that they injected Lymphoseek, which is a radioactive solution designed to identify the lymph nodes that drain from a primary tumor. But this is a clear solution and not dark blue. There was no blue dye on my right breast, so they must have just added it to the left breast when they did the injection, since that was the one that had cancer. I don't know how it got all over the outside of my skin.
Glori, f you are going have dye injected for the purpose of finding the lymph nodes, I suggest you get tested ahead of time to see if you have a reaction to it. It's rare, not fun if you do. You could ask them to just use Lymphoseek to find them without the blue dye. I read that the dye is only very slightly more accurate in finding the lymph nodes. If you do decide to have the blue dye, be aware that your urine will be green for several days afterward. I wouldn't worry about the pain. I hope you have a much better outcome than I did.

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Wow, sounds terrible. I am sorry. Breast cancer is a difficult journey. I had dye to find sential node but it was not in niple but the actual lump as my lump was close to outer surface. Not really painful as I used a numbing cream before leaving for hospital and they also numbed it. I had no problems with it. The estrogen meds are no fun either but life will get back to a new normal and you will be able to focus on the positive. Hang in there I thought I would never feel good again or be at peace. You will, in time, just try to focus on the good in each day, pray often, and love the things and people that you love. Normal will never be as it was before bc but can still be great. I had bilateral bc, stage 1 in left breast, stage2b in right., Bi-lateral Mastectomy, chemotherapy, reconstruction, Exemestane, estrogen blocker, 6 years now. I have had 1 hip replacement and numerous shoulder surgery prior to cancer, 6 I will be 7 years in remission this Nov., I had 2 positive nodes so recurrence is definitely a possibility.
Currently I am waiting to have other hip replaced and another reconstruction revision. Both at different times as soon as covid 19 allows. No fun but I try even though it can be discouraging , I try to focus on the positive things in my life. I guess I am just so thankful to have all this available to me as others in the past did not. Good luck. May God be with you. Hang in there. Think about living and better days a head.
Look forward to getting past all of thi s. Life will seem more precious

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I had this done prior to my lumpectomy and sentinel node biopsy at The Mayo Clinic In Jacksonville last year. It was painless.

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I did too and I agree with your comments.

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