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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

    diagnostic mammogram/ultrasound today, lump left breast. solid mass, 6 enlarged lymph nodes in left underarm, two more solid masses growing on each side. three biopsies next Friday (2 on left, 1 on right). Freaking out

    Asked by anonymous

    Learning About Breast Cancer
    almost 5 years 10 answers
    • View all 10 answers
    • Mimi Carroll Profile
      anonymous
      Learning About Breast Cancer

      Yikes !!! The waiting is soooo hard.... Try to fill up time so you won't worry too much..,,

      Comment
    • Roberta S Profile
      anonymous
      Stage 2B Patient

      Don't panic!! Just finish the testing and pray. Bc is different than it used to be and there are so many awesome treatments out there now. Ill say a prayer for u! :)

      Comment
  • Thumb avatar default

    I have just been diagnosed with Granulomatous Mastitis because my core biopsys and FNA's came back as not containing cancer cells. Does this happen with every breast lump found?

    Asked by anonymous

    Learning About Breast Cancer
    almost 2 years 2 answers
    • Betti A Profile
      anonymous
      Survivor since 2013

      The majority of breast lumps are benign but if they are concerned they recommend a biopsy to determine what it is as that is the only way to find out.

      Comment
    • Nat Caldwell Profile
      anonymous
      Learning About Breast Cancer

      What I actually meant was, do they give the diagnosis of it being "Granulomatous Mastitis" every time, when they don't find any actual cancer cells.

      1 comment
  • Thumb avatar default

    The surgeon said he removed 25 lymph nodes and 10 were cancerous. Does this mean it has probably spread elsewhere? Are these numbers normal?

    Asked by anonymous

    Learning About Breast Cancer
    about 6 years 2 answers
    • Diana Foster Payne Profile
      anonymous
      Stage 4 Patient

      As Sharon said...every woman is different. I had 15 lymph nodes removed and 13 of those were cancerous. It doesn't necessarily mean that your cancer has traveled past the lymph nodes. Your dr. May want to do more testing to make sure. I had chemo before my surgery. Then had to have more...

      more

      As Sharon said...every woman is different. I had 15 lymph nodes removed and 13 of those were cancerous. It doesn't necessarily mean that your cancer has traveled past the lymph nodes. Your dr. May want to do more testing to make sure. I had chemo before my surgery. Then had to have more afterwards. When they found the positive nodes...some of them were "extranodal" meaning the cancer had broken outside some of the lymph nodes. That was the reason I needed more chemo. I'm going through radiation now. I'm also happy to say that my last PET scan showed no cancer!! Voice your concerns with our Dr. Yes, let us know how you are. Prayers to you. :)

      Comment
    • Sharon Danielson Profile
      anonymous
      Survivor since 2007

      It means it has spread from the original tumor. Your doctor will probably want additional testing of the type of tumor and the aggressiveness of the cells. I had 5 sentinal lymph nodes removed and one was positive for cancer. I hope you keep us posted as your treatment continues. We, on this...

      more

      It means it has spread from the original tumor. Your doctor will probably want additional testing of the type of tumor and the aggressiveness of the cells. I had 5 sentinal lymph nodes removed and one was positive for cancer. I hope you keep us posted as your treatment continues. We, on this board, want to support every woman who is going through this journey. All of our stories are different but we all care for each other.
      Take care, Sharon

      4 comments
  • jc lin Profile

    I had a mastectomy and auxiliary node dissection and reconstruction done on the 24th. Going for my first follow up with the PS today. My new breast, especially under arm are swollen, does not hurt but concern....how long will it take to go down?

    Asked by anonymous

    Patient
    over 5 years 4 answers
    • View all 4 answers
    • Erin Timlin Profile
      anonymous
      Survivor since 2011

      Did you have a drain? The purpose is to drain out the fluid (that my doctor called "weeping) so that it doesn't collect. I had mine out after 8 days, and my doc told me that even if fluid did collect it would be harmless. Eventually the body would reabsorb it. If it's a lot of fluid and it...

      more

      Did you have a drain? The purpose is to drain out the fluid (that my doctor called "weeping) so that it doesn't collect. I had mine out after 8 days, and my doc told me that even if fluid did collect it would be harmless. Eventually the body would reabsorb it. If it's a lot of fluid and it does start to cause discomfort then they can easily use a needle to drain some of it. Doesn't sound pleasant, but I am sure it provides relief! Good luck!

      5 comments
    • Monica Sterling Profile
      anonymous
      Patient

      I had the same in February 2012, and I didn't notice the swelling gone until late May actually. The numbness is still in several areas which my doctor told me may or may not go away. Good Luck and be patient on your recovery, it takes a while. You had Major surgery which by all standards takes...

      more

      I had the same in February 2012, and I didn't notice the swelling gone until late May actually. The numbness is still in several areas which my doctor told me may or may not go away. Good Luck and be patient on your recovery, it takes a while. You had Major surgery which by all standards takes time.

      1 comment

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