sentinel node positive

anaumann
anaumann Member Posts: 60 Member
edited March 2014 in Breast Cancer #1
thanks for all the advise. I never think of questions when I get bad news at drs office. My sentinel node was positive in addition to cancer cells around the lumpectomy. Now I have to get scheduled for masectomy...but I did not ask more questions. Will all lympth nodes be removed? How much more difficult does this make for recovery? Will I still need radiation or chemo or both?? I keep trying to stay positive but I keep getting more bad news. ann

Comments

  • cahjah75
    cahjah75 Member Posts: 2,631
    #2
    Ann
    I'm not too sure because my sentinel node was negative. Post mastectomy recovery goes well as long as you follow dr instructions. My sister did have more lymph nodes removed and 7 of hers were positive. She had lumpectomy, chemo and rads. I'm sure this will be something you will discuss with oncologist after you've healed from mastectomy. Keep asking questions. I'm sure someone will post who might know more than me. But your surgeon, oncologist, etc will ultimately explain what your options are and plan treatment.
    {{hugs}} Char
  • lookrider
    lookrider Member Posts: 10
    #3
    sentinel node positive
    i too had a positive sentinel node and ended up with an axillary node dissection. in all honesty, it was no picnic. for me it was harder than the bilat mastectomy with the snb. maybe this was due to the fact that i was only one week post op from the first surgery. the surgeon did take all of my nodes but i have talked with others who have had anywhere from a few to 2/3rds removed. i do not know what the criteria is for how many are removed. i am having lots of arm pain and numbness but hopefully it will be temporary as i am only three weeks out. women with lumpectomies usually require radiation and those with mastectomies sometimes do not; different for each of us.... lots of factors. i do not know if i will need chemo until the results of the oncotype dx test are back. has your oncologist talked with you about this test?
  • Mama G
    Mama G Member Posts: 762
    #4
    lookrider said:

    sentinel node positive
    i too had a positive sentinel node and ended up with an axillary node dissection. in all honesty, it was no picnic. for me it was harder than the bilat mastectomy with the snb. maybe this was due to the fact that i was only one week post op from the first surgery. the surgeon did take all of my nodes but i have talked with others who have had anywhere from a few to 2/3rds removed. i do not know what the criteria is for how many are removed. i am having lots of arm pain and numbness but hopefully it will be temporary as i am only three weeks out. women with lumpectomies usually require radiation and those with mastectomies sometimes do not; different for each of us.... lots of factors. i do not know if i will need chemo until the results of the oncotype dx test are back. has your oncologist talked with you about this test?

    Mine was also positive
    and they removed 9lymph nodes, 8 of which were positive. From what I understand your nodes are in a cluster, kind of like a spider web and they will remove all until they get a clear node. I guess the cancer cells travel down the line and they know the rest will be clear.
    So they don't like to take out all of your nodes any more like they did in the old days.
    The recovery time is no different as far as I know, but the treatment might be. I had the typical ACT chemo and 35 Radiation treatments. They pretty much destroy the leftover area with the rads so that it won't come back to what's left over. The chemo sucked , but all the rest was doable.
  • greyhoundluvr
    greyhoundluvr Member Posts: 402
    #5
    Ann -
    It sounds like this may be another area where the doctors take different approaches. I opted for a bilateral mastectomy up front (instead of lumpectomy)and they did my sentinel node biopsy at the time of surgery. Although my tumor was very small and early grade, my mother had breast cancer so I opted to be aggressive with the surgery. To everyone's surprise, my sentimel node biopsy was positive as well (my surgeon considered me low risk for node involvement). My surgeon took out 15 nodes (2 were positive). The way he had explained it, they may take more if the the nodes look abnormal but typically do not remove them all.

    I would say that the lymph node removal does make you sorer and you have to work a little harder during your recovery to get your range of motion back in your arm because it is tighter. I stayed overnight in the hospital (I also had tissue expanders put in which adds to the discomfort) but went home the next day and did fine with the pain meds.

    Initially we thought I would not have to have chemo, but the positive nodes made that a necessity. The impression that I got from my oncologist is that this is standard. The radiation is a little more iffy and may depend on how many you have and what your docs think. From what I have read, 1-3 posaitive nodes is a gray area. 4 or more they will usually do radiation but mine said that it cuts the risk of recurrence so significantly that she wanted me to have it and the radiation oncologist agreed.

    I know that you have a lot coming at you right now and a lot of decisions to make. While everyone would prefer not to have positive lymph nodes, there are many women out there who have done very well with these findings and it likely still an early stage of breast cancer - it just means we have to jump through some extra hoops. You may want to consider going ahead and seeing the oncologist who can help you understand everything you need to know if you haven't done this already.

    I am sorry your news wasn't as good as you had hoped but we will all be here to help you get through this.

    Chris
  • anaumann
    anaumann Member Posts: 60 Member
    #6
    greyhoundluvr said:

    Ann -
    It sounds like this may be another area where the doctors take different approaches. I opted for a bilateral mastectomy up front (instead of lumpectomy)and they did my sentinel node biopsy at the time of surgery. Although my tumor was very small and early grade, my mother had breast cancer so I opted to be aggressive with the surgery. To everyone's surprise, my sentimel node biopsy was positive as well (my surgeon considered me low risk for node involvement). My surgeon took out 15 nodes (2 were positive). The way he had explained it, they may take more if the the nodes look abnormal but typically do not remove them all.

    I would say that the lymph node removal does make you sorer and you have to work a little harder during your recovery to get your range of motion back in your arm because it is tighter. I stayed overnight in the hospital (I also had tissue expanders put in which adds to the discomfort) but went home the next day and did fine with the pain meds.

    Initially we thought I would not have to have chemo, but the positive nodes made that a necessity. The impression that I got from my oncologist is that this is standard. The radiation is a little more iffy and may depend on how many you have and what your docs think. From what I have read, 1-3 posaitive nodes is a gray area. 4 or more they will usually do radiation but mine said that it cuts the risk of recurrence so significantly that she wanted me to have it and the radiation oncologist agreed.

    I know that you have a lot coming at you right now and a lot of decisions to make. While everyone would prefer not to have positive lymph nodes, there are many women out there who have done very well with these findings and it likely still an early stage of breast cancer - it just means we have to jump through some extra hoops. You may want to consider going ahead and seeing the oncologist who can help you understand everything you need to know if you haven't done this already.

    I am sorry your news wasn't as good as you had hoped but we will all be here to help you get through this.

    Chris

    thanks again to all for the
    thanks again to all for the info and support, ann
  • missrenee
    missrenee Member Posts: 2,136 Member
    #7
    anaumann said:

    thanks again to all for the
    thanks again to all for the info and support, ann

    Hi Ann-
    I had a lumpectomy, with an axillary node dissection since my sentinal node was positive as well as 9 others out of the 23 my surgeon removed. I have to be honest with you and say that, for me, the axillary node dissection was the worst part. I'm 10 months post-op, still have some pain, swelling and numbness at times. My surgeon said this may never totally subside, but it is better than initially. He said that every person has a different number of nodes and he has seen some with as little as 15 and as many as 60. As another person said, they come in clusters.

    I do PT with a therapist who specializes in breast cancer patients and have a massage technique to do also. I also must wear a compression sleeve and gauntlet (for the hand) when I fly to ward off lymphedema in that arm. This might be a forever thing.

    Do know, however, that every patient is different and every procedure seems to be individual. Also, in the whole scheme of things, this is definitely do-able.

    Good luck with your treatment and results.

    Hugs, Renee

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