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Treatment

 
Treatment

Chapter: 6 - Treatment

Subchapter: 6 - Lymph Node Removal

In addition to your surgical procedure, your doctor may wish to remove and examine lymph nodes; this is to determine whether the cancer has spread and to what extent. Your doctor will perform a Sentinel Lymph Node Biopsy and/or an Axillary Node Dissection. Let’s discuss both methods.

Sentinel Lymph Nodes and Sentinel Node Biopsy
While it is not easily controlled, the spread of cancer is sometimes predictable. The cancer cells spread through a customary path, out from the tumor and into the surrounding lymph nodes, before they progress throughout the body.

To be able to identify the sentinel lymph node, the surgeon will inject dye or a radioactive tracer into the tissue near the tumor; the lymph nodes that are the most susceptible to the cancer’s spread will be marked by the dye or a radioactive tracer. During surgery, the lymph nodes will be removed and checked for the presence of cancer cells.

Axillary Node Dissection
To determine if the cancer has spread to the lymph nodes, examinations can be performed with ultrasound and more carefully by removing one or more of the first draining lymph nodes with sentinel lymph node biopsy. Patients with a tumor that has spread to these lymph nodes may require complete removal of the lymph nodes in the armpit, a procedure known as an axillary lymph node dissection. An axillary dissection is generally performed subsequent to a sentinel lymph node biopsy, unless a woman has had a positive fine needle aspirate of a lymph node.

A mastectomy or lumpectomy operation often includes a sentinel node biopsy and/or an axillary node dissection; both procedures involve a separate incision for lumpectomy patients. Following surgery, the pathologist will test the lymph nodes to determine whether the cancer has spread to the lymph nodes.

Lymphedema
Removing lymph nodes raises your risk for developing Lymphedema, a condition that may cause abnormal swelling of the arm, breast, axilla, or chest wall on the side of your cancer. Swelling up to one month after surgery is not unusual and does not indicate the presence of lymphedema. However, if you experience new or persistent swelling in these areas after one month has elapsed since your surgery, you should notify your doctor.

Related Questions

  • Thumb avatar default

    can the stage of breast cancer be determined without a biopsy?

    Asked by anonymous

    Learning About Breast Cancer
    almost 6 years 3 answers
    • Thumb avatar default
      anonymous
      Survivor since 2012

      The short answer is no. Margins around the tumor and lymph node involvement along with possible spread outside these areas must be established.

      Comment
    • Marianne R. Profile
      anonymous
      Survivor since 2011

      No the tissue needs to be studied by the pathologists.

      Comment
  • Thumb avatar default

    I had a biopsy on Friday. They hurt me bad. The tumor was located on top of a muscle and the Dr. hit the muscle 3 times during the procedure. I made her stop. Should I change surgeons?

    Asked by anonymous

    Stage 0 Patient
    about 5 years 7 answers
    • View all 7 answers
    • Jo Norwood Profile
      anonymous
      Survivor since 2012

      I had 4 cores. My surgeon did it. I had a numbing shots directly to the area. Didn't feel the incision for the gun. The first two cores were uncomfortable but the third was excruciating . Dr apologized and said the tumor couldn't be numbed. He said it was the densest tumor he had ever biopsies....

      more

      I had 4 cores. My surgeon did it. I had a numbing shots directly to the area. Didn't feel the incision for the gun. The first two cores were uncomfortable but the third was excruciating . Dr apologized and said the tumor couldn't be numbed. He said it was the densest tumor he had ever biopsies. The fourth hurt like$&@?. He ask me if I could take the 4th to get the best info possible. My suspicious area was the size of a golf ball and the tumor turned out to be 2.7 cm. he told me he was 99%sure it was cancer. Two weeks later I had surgery. I never worried about spread because I had cancer already. If it was so aggressive the biopsy could spread it , that would be the least of my fears. If you don't trust your dr change, but keep in mind sometimes our disease presents them with the dilemma of doing harm .

      Comment
    • Sharon Danielson Profile
      anonymous
      Survivor since 2007

      I would have completely lost confidence..... Make a change, and take care, Sharon

      Comment
  • Thumb avatar default

    I just had a lumpectomy and sentinel node biopsy positive. The doctor said that after my lumpectomy I would have radiation, but the sentinel node being positive makes me wonder what treatment would be best.

    Asked by anonymous

    Learning About Breast Cancer
    over 6 years 5 answers
    • View all 5 answers
    • vicki e Profile
      anonymous
      Stage 2B Patient

      Four years ago I was diagnosed with stage 2b idc. I also had two positive nodes. I had a mastectomy, chemo and radiation. my docs assured me that the chemo and rads would take care of the two positive nodes and did not remove them. Fast forward to march 1,2012 and my two positive nodes were now...

      more

      Four years ago I was diagnosed with stage 2b idc. I also had two positive nodes. I had a mastectomy, chemo and radiation. my docs assured me that the chemo and rads would take care of the two positive nodes and did not remove them. Fast forward to march 1,2012 and my two positive nodes were now nine positive nodes. I am doing chemo again. I am not a happy camper. I questioned the decision not to trove them but wish I had thrown an all out hissy fit and insisted. I don't think I would be going through this again. If you decide to insist on the node removal, don't apologize to anyone and stand your ground. I wish I had. Docs are human and make mistakes. Go with your gut because you know your body best. My doc thought I was being a whiny butt. I should have been a screaming banshee ! Good luck and keep us posted.

      Comment
    • Thumb avatar default
      anonymous
      Learning About Breast Cancer

      I was in the same situation. I was told before my lumpectomy I would only need radiation. My sentinel lymph nodes were positive so now I am having chemotherapy then radiation then femora for 5 years. Ask your surgeon. My surgeon told my husband about the need for chemotherapy right after he...

      more

      I was in the same situation. I was told before my lumpectomy I would only need radiation. My sentinel lymph nodes were positive so now I am having chemotherapy then radiation then femora for 5 years. Ask your surgeon. My surgeon told my husband about the need for chemotherapy right after he completed my surgery.

      Comment
  • Thumb avatar default

    Is it common to have two biopsy's in the same breast? One at an ultrasound and another during an MRI?

    Asked by anonymous

    Stage 0 Patient
    about 5 years 6 answers
    • View all 6 answers
    • Rayleen Lima Profile
      anonymous
      Learning About Breast Cancer

      Yes. That is how men was detected. 1st a mammo, then a 2 nd mammo & an ultrasound on the same day. The ultra sound didn't show what they saw in the mammo so I was then scheduled a MRI. Actually, the ultrasound wasn't a biopsy.

      Comment
    • Tiffani Warila Profile
      anonymous
      Learning About Breast Cancer

      I had a core needle biopsy that showed "atypical" cells. My surgeon didn't like that so he did a surgical biopsy which showed the cancer.

      Comment

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