Sentinel node qestion

seof Member Posts: 819 Member
edited March 2014 in Breast Cancer #1
This is SEOF. I thought I was going to respond to another person's question, but I have my own about the same subject, so I thought I'd better not try. As I understand it, there would be 2 reasons not to take out more nodes: a) to reduce chances of the arm swelling due to poor circulation/drainage of the lymphatic fluid and b) just the general idea of doing less surgery if possible. It seems to me that if the nodes are swollen, there may be something wrong with them, even if it is not cancer, so removal may be good. On the other hand, I had a friend who had several nodes removed and she suffered quite a bit from swelling and discomfort in that arm, which I would like to avoid, if possible. It is quite a dillemma. I am still doing chemo treatments and the time to decide that issue is still a few weeks off, but I do have some enlarged tissue of some kind in the area, and some of the nodes looked suspicious on the ultrasound before chemo was started, so we will address it when the time comes. Any thoughts?



  • Melaniesmom
    Melaniesmom Member Posts: 8
    I think it has to do with your surgeon. Mine was a breast conservation surgeon and I had a full mastecomy and 10 nodes taken - 5 in breast and 5 from pit. I haven't had any swelling problems. I have a weird tenderness (the best way to describe it) on the back side of my armpit and numbness where I know I'm touching it but it feels like it is asleep. Of course I don't have anything done to my left arm - no bp, needles or draws. No discomfort just from not having a boob to lay on at night, but a pillow helps that.

    Discuss with your doctor after the chemo has shrunk or not shrunk the nodes. They are still in there cutting away, they take sometimes what they think is best.
  • phoenixrising
    phoenixrising Member Posts: 1,508
    Hi, maybe they could do another ultrasound after chemo and before surgery. Or MRI, to get the full picture. I let them take my sentinels only.
    They got 6 and and 3 were positive. My surgeon wanted to take out the axillary but conceded that it probably wasn't necessary since I would be doing chemo anyway. She also stated that some surgeons were saving the axillary and only taking the sentinels. I didn't want future problems with my arm and have tried to walk the fine line between being disabled by this and coming out the other side whole. I don't know if it was the right decision or not. Done now I guess.

    Best of luck to you
  • cabbott
    cabbott Member Posts: 1,039 Member
    My surgeon planned to take just the sentinel node. He aimed for 2 and got 3 because a little one was hiding under the area he removed. If they had been positive in the operating room (they weren't) he would have proceeded to remove more so that I could be properly staged. If many of the nodes are positive, you know you are working with an aggressive cancer that can already set up camp elsewhere (other than the breast), so you need to continue with an aggressive treatment. They used to think that more surgery would stop the cancer from proceeding, but later found that totally removing all the nodes from the arm and chest (they even went for the ones between the ribs!) didn't increase survival time or time to progression. Ask your surgeon how many he thinks he should take out to properly stage you should the nodes show up positive. Less out protects your arm function, but more out than necessary will not stop this beast. Taking out positive nodes, though, might slow it down. I hope yours are all negative!

  • Bunnysmama
    Bunnysmama Member Posts: 3
    I agree with cabbott. My surgeon explained to me that she was going for the sentinel nodes only. When she had removed them, they would immediately be sent to the lab as a frozen section or "quick look." If the pathologist found the sentinel nodes to be clear, surgery was over. If the frozen section came back with suspicious results, then she would go for the full axillary dissection. The only other way she would do the axillary dissection is if she wasn't able to locate the sentinel nodes.

    Fortunately for me, she did find and remove the sentinel nodes and they were clear. I had that tingling "asleep" sensation for a while after the surgery in my armpit area, but it has slowly improved. I still take as many precautions as I can, though, to prevent any possible swelling. I never have my blood pressure taken on that arm, or bloodwork, and I try to carry things with my other arm as well.

    Good luck! I hope your nodes prove to be negative.