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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

    Where does breast cancer usually spread to first if it spreads?

    Asked by anonymous

    Learning About Breast Cancer
    almost 8 years 2 answers
    • Diana Foster Payne Profile
      anonymous
      Stage 4 Patient

      The most common places breast cancer can spread to are the lymph nodes, the muscle tissues in the chest wall, etc, the bones, bone marrow, lungs, liver, & brain.

      Comment
    • Ali S Profile
      anonymous
      Survivor since 2011

      It has to break out of duct first, but sentinel nodes are the first places it likes to go

      Comment
  • Christa M Profile

    Waiting for biopsy results is driving me crazy. Had my biopsy one Thursday so I should know by the end of the week,

    Asked by anonymous

    Learning About Breast Cancer
    over 7 years 4 answers
    • View all 4 answers
    • Sharon Danielson Profile
      anonymous
      Survivor since 2007

      MEEEE TOOOOO! It is so terrifying and sickening to have to wait. Try to keep in mind doctors are doing lots of biopsy's because they strive to be pro-active. One of the gripes of the insurance company's is too many are done. So many of these biopsy's come back benign. We, as humans, always...

      more

      MEEEE TOOOOO! It is so terrifying and sickening to have to wait. Try to keep in mind doctors are doing lots of biopsy's because they strive to be pro-active. One of the gripes of the insurance company's is too many are done. So many of these biopsy's come back benign. We, as humans, always go to the dark side. Arrrrgh. Please keep us posted, I hope it all comes back benign. I will share with you my radiologist told me, straight up, at the biopsy, "It would come back positive." She was right but today, I am cancer free!!!

      I hope and pray the time goes by quickly and you will be ok. Hang in there, we all know what you are going through.

      Sharon

      Comment
    • Ali S Profile
      anonymous
      Survivor since 2011

      The waiting and unknown can be horrible. Try to surround yourself with people and things to do to keep your mind off it! I'm keeping my fingers crossed for you. Hearing that my tumor was a small cancer at age 31 made me feel like I was hit by a truck. But I too, am cancer free and about to...

      more

      The waiting and unknown can be horrible. Try to surround yourself with people and things to do to keep your mind off it! I'm keeping my fingers crossed for you. Hearing that my tumor was a small cancer at age 31 made me feel like I was hit by a truck. But I too, am cancer free and about to turn 33.

      Comment
  • jan bursky Profile

    Has anyone had invasive lobular cancer metastasize despite mastectomy and chemo? Stage 3 and loss of lymph nodes are involved. Very scary.

    Asked by anonymous

    Learning About Breast Cancer
    over 7 years 6 answers
    • View all 6 answers
    • Sharon Danielson Profile
      anonymous
      Survivor since 2007

      10 years ago, my best friend had stage 4 Invasive Lobular Breast Cancer. She had 4 rounds of AC before a mastectomy and complete axillary removal of nodes. 17 out of 21 nodes were positive. She was scheduled for different chemo treatments but would only allow radiation. After the radiation,...

      more

      10 years ago, my best friend had stage 4 Invasive Lobular Breast Cancer. She had 4 rounds of AC before a mastectomy and complete axillary removal of nodes. 17 out of 21 nodes were positive. She was scheduled for different chemo treatments but would only allow radiation. After the radiation, she refused any other treatment. She lived for 5 years until it metastisized to her bone marrow. She passed away just as I found out I had breast cancer. She said she'd lived long enough and died at age 64. It still upsets me that she gave up the fight before she had even begun. It was her life and her decision but her loss left a big hole in the hearts of many people. Sharon

      Comment
    • Patricia Stoop Profile
      anonymous
      Learning About Breast Cancer

      Oh prayers for you. Very scary. I had liver masses too and found meditation a great help!

      Comment
  • Susan Green Profile

    My oncologist said that cancer could have spread even though I had a mastectomy with negative lymph nodes. Has anyone had this happen?

    Asked by anonymous

    Patient
    almost 8 years 6 answers
    • View all 6 answers
    • Sharon Danielson Profile
      anonymous
      Survivor since 2007

      I think it all depends on the pathology of the breast cancer. There are so many other findings once a detailed report comes back one needs more information. Did you doctor say this in a context of recommending further treatment such as chemotherapy or radiation? There is probably always a...

      more

      I think it all depends on the pathology of the breast cancer. There are so many other findings once a detailed report comes back one needs more information. Did you doctor say this in a context of recommending further treatment such as chemotherapy or radiation? There is probably always a possibility of a cancer spreading but you / we need more information. If you are unsure about additional treatment, I would advise you to get a second opinion. Susan, good luck to you. There are a ba-zillion of us alive and well post breast cancer!

      4 comments
    • Sharon Danielson Profile
      anonymous
      Survivor since 2007

      Well, dang I wrote a whole long bla-bla and somehow it vanished. The testing your doctor is waiting for is probably an "Oncotest DX" This test looks at the actual tumor cells and pathologists are able to grade them as to their probability of recurrance. If they are a higher grade on the scale,...

      more

      Well, dang I wrote a whole long bla-bla and somehow it vanished. The testing your doctor is waiting for is probably an "Oncotest DX" This test looks at the actual tumor cells and pathologists are able to grade them as to their probability of recurrance. If they are a higher grade on the scale, they will recommend further treatment. This way, if they are a low grade for recurrance, you won't be receiving unnecesary treatment. My brother-in-law had breast cancer and the onco DX and his cells were so low grade he didn't have to have any further treatment after his mastectomy. I did not have an onco test 4 years ago because I had one positive lymph node. (BUT...) My oncologist had just returned from a breast cancer symposium and there had been a completion of a study which benefited me. I only had to have 4 rounds of chemo because of the study because the study showed any more chemo would NOT benefit my type of breast cancer.....YAHOOOO! . Every single day, little advancements are made in diagnostics and treatments. The way it is going, treatments are becoming less drastic than they were in the past. This test you are waiting for does take longer than the other pathology for your tumor. This will be the final one in the line of all the diagnostics. You will move along to the next step. Susan, don't worry.... you will be ok. There are a ton of positive stories out here. Women are living long lives. I hope you keep in contact. We are a great big supportive group out here. We want to help other sisters who are going through this all too common battle. Again, please stay in touch. All the best to you, we all know what you are going through. Big healing hugs, Sharon

      Comment

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