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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

    Im 27 and have had a lump in my left breast since i was like 14. This week I went to get an ultrasound, and was told the lump was lobular, big, and had veins. I have to go back for a biopsy. Do you think this could be cancer?

    Asked by anonymous

    Learning About Breast Cancer
    over 7 years 2 answers
    • Diana Foster Payne Profile
      anonymous
      Stage 4 Patient

      There are so many different types of lumps. Your Dr is being through by doing a biopsy. It's so much better to be safe than sorry. I know how scary it is. I've been there. Please know that 80% of biopsies end up being benign. I will think positive thoughts & pray that you're in that 80%. Hang in...

      more

      There are so many different types of lumps. Your Dr is being through by doing a biopsy. It's so much better to be safe than sorry. I know how scary it is. I've been there. Please know that 80% of biopsies end up being benign. I will think positive thoughts & pray that you're in that 80%. Hang in there. Hugs, Diana. :)

      2 comments
    • J G Profile
      anonymous
      Learning About Breast Cancer

      As hard as it is.....Try not to jump to conclusions. Like Diana says" there are so many types of lumps and the greater percentage are negative.

      1 comment
  • Thumb avatar default

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

    Asked by anonymous

    Learning About Breast Cancer
    almost 7 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

    Has anyone else been in this position? I have to have a repeat mammogram and ultrasound on density of the left breast. I had a biopsy last year.

    Asked by anonymous

    Learning About Breast Cancer
    over 7 years 2 answers
    • Sharon Danielson Profile
      anonymous
      Survivor since 2007

      Arrgh! Hate the call-backs. I would suggest one more test and that would be an MRI.
      It can show up small changes very clearly. MOST of these call-backs turn out to be NOTHING! Take care, Sharon

      Comment
    • Marianne R. Profile
      anonymous
      Survivor since 2011

      No one likes call backs BUT better to go and get a "nothing" than to go and miss breast cancer. Mine was found in a call back the 3 other call backs were clear number 4 was invasive lobular and rarely shows up even the MRI said show about 2 cm the cancer turned out to be 7.3 cm.

      Comment
  • Thumb avatar default

    Has anyone gone in for a lumpectomy and sentinel node biopsy and come out with a partial mastectomy axilllary lymph node dissection?

    Asked by anonymous

    Stage 2A Patient
    over 7 years 2 answers
    • Sharon Danielson Profile
      anonymous
      Survivor since 2007

      I don't think this is all that uncommon. I remember my mastectomy was late because the woman before me ended up with a mastectomy and axillary lymph node dissection. Tests can only show so much and things can change once the surgeon starts the actual surgery. It is a shock to wake up and...

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      I don't think this is all that uncommon. I remember my mastectomy was late because the woman before me ended up with a mastectomy and axillary lymph node dissection. Tests can only show so much and things can change once the surgeon starts the actual surgery. It is a shock to wake up and discover things didn't go as expected. My surgeon told me my 5 sentinal nodes were clear. After the actual complete pathology was done, one of the nodes had a small area of cancer and my diagnosis went from a 2A to a 2B.
      I was pretty upset. This probably happens a lot more than one would think.
      Take care, Sharon

      Comment
    • Thumb avatar default
      anonymous
      Survivor since 2012

      Yep. I was to have a lumpectomy at the bottom of the breast and up to the edge of the areola. I told him if he had to take the areola and nipple to take the whole thing He drew on me so I could see what he PLANNED to do based on the core biopsy and ultrasound and how he would arrange the the...

      more

      Yep. I was to have a lumpectomy at the bottom of the breast and up to the edge of the areola. I told him if he had to take the areola and nipple to take the whole thing He drew on me so I could see what he PLANNED to do based on the core biopsy and ultrasound and how he would arrange the the tissue. My 3 sentinel nodes were clean and he got good margins but I ended up with a partial mastectomy. The incision is well hidden in the crease beneath my breast but he had to cut to the base of the nipple and remove a tiny secftion of the areola. He did a great job piecing me back together. Until they get in there and the all the tests results are in, the final product can be an unknown to us until we wake up. Cancer has a nasty way of messing up the best plan our doctors try to accomplish for us. Good healing to you. Jo

      Comment

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