Topic: Sentinal Node Biopsy and DCIS
- Posted on: Nov 6, 2009 02:37 pm
Posts: 30
I had a very small amount of DCIS found on one breast and a ton of a atypia on both. I decided to go with a bilateral mastectomy. I found out today, they are doing a sentinal node biopsy. One, can you tell me what that is like. Two, is that normal?
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TOB Joined: Aug 2009 Posts: 37 |
Nov 6, 2009 05:15 pm
TOB wrote:
Rosiesmom, I know how a SNB (sentinal node biopsy) is performed, but since I won't have one until 11/19, I will leave the answer to that part of your question to others who have gone before us. What I can tell you is that SNB in patients with DCIS continues to be a source of disagreement in the literature and in practice. The risk of complications from SNB is low, but complications such as lymphedema, seroma, infection and sensory neuropathy have been reported after the procedure. When I was just going to have a lumpectomy, SNB was not considered to be necessary unless the pathology revealed microinvasion. After reading the literature, I understood why. By definition DCIS is contained within the milk ducts, and cannot therefore, metastasize to the lymph nodes. That can change, however, in those cases where DCIS has invaded or broken through the wall of the milk ducts and into the surrounding breast tissue. Neither of the path reports from my 2 lumpectomies indentified any microinvasion, so another procedure to do sentinal node mapping and excision was not performed. Now that I will be having a mastectomy, they are going to do a SNB, primarily because sentinal node mapping cannot be performed after a mastectomy has been done. The finding of lymph node metastasis in pure breast DCIS (without microinvasion) is not unknown, but is a very rare occurence if the primary tumour has been completely excised and microinvasion has been ruled out by a thorough histologic examination by an experienced pathologist. It is done in conjunction with a mastectomy to insure that occult metastases are not missed. The chance they will find anything is quite low, but if you have to go through such an extensive procedure for Stage 0 cancer, knowing that they got it all and there is no occult disease identified will help you sleep at night. |
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rubybuttons… Joined: Nov 2008 Posts: 470 |
Nov 6, 2009 09:38 pm, edited Nov 6, 2009 09:39 PM
by rubybuttons
rubybuttons wrote:
I had Dcis in one breast also. SNB was supposed to be done at the time of my bilat mx but because i had to wait several months for surgery (and I didn't want to have an MRI) my breast surgeon decided to do it separately a month prior to the mx. It was about a 1/2 hour surgery. Went home several hours later. The only "iffy" part that I recall was the dye injection into the nipple. It was not painful for me just a little weird. surgery and recovery was no big deal, no problems or much pain afterwards. The dye does make you a lovely shade of gray for a day and you will pee smurf blue for a few days. I think a SNB is pretty standard procedure if you are having a MX. Diagnosis: 10/15/2008, DCIS, Stage 0, Grade 3, 0/10 nodes, ER+ |
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dmorgan2 Joined: Oct 2009 Posts: 29 |
Nov 9, 2009 01:37 am
dmorgan2 wrote:
Rubybuttons, were you really sore, etc. after the SNB? You didn't have any swelling? I'm about to have one with my left mx in 9 days!!!! I'm requesting it from the surgeon (DCIS). Diagnosis: 8/21/2009, DCIS, 1cm, Stage 0, Grade 2, 0/0 nodes, ER+/PR- |
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mawhinney Joined: Jun 2008 Posts: 630 |
Nov 9, 2009 04:16 pm
mawhinney wrote:
You can read about lymph node biopsies on this site. Go to the section Treatments and Side Effects and click on Surgery. You will find info on node biopsies. I had a sentinel node biopsy at the time of my unilateral mastectomy. The day before radioactice dye was injected in my arm to enable the BS to locate the sentinal node. That procedure was easy. The incision was tiny - less than an inch. It did ache more and take longer to heal than the mastectomy incision was not really a problem. good luck. Diagnosis: 5/18/2008, IDC, <1cm, Stage Ib, Grade 2, 0/1 nodes, ER+/PR+, HER2- |
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rascal_gal Joined: Dec 2008 Posts: 68 |
Nov 11, 2009 04:21 pm
rascal_gal wrote:
I had the mapping done before my MX, during the mastectomy they did the SNB. I could only tell they did it because the scar on my right breast goes up to my arm pit, where my other scar doesn't. I never had complications from the SNB either. Although when I go in for procedures that call for IV's and blood pressure cuffs, they will not use my right arm. They put the pressure cuff on my left ankle and do blood work and IV's thru my left arm. Bilateral Mastectomy w/tissue expanders 33-03-09 /Exhange surgery 7-17-09/ Natrelle Style 20 475 high profile
Diagnosis: 1/5/2009, DCIS, 4cm, Grade 2, 0/1 nodes |
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kime Joined: Sep 2009 Posts: 92 |
Nov 11, 2009 05:47 pm
kime wrote:
I had a lumpectomy for DCIS, they decided to do a SNB because my DCIS was high grade with comedo necrosis, it was done to be on the safe side, in case there had been any invasion that they could not see. I was told that 1 to 3 nodes would be removed, they removed 2. It was sorer than the lumpectomy area and the soreness lasted longer in that area, but it wasn't bad and there were no other problems. Diagnosis: 8/13/2009, DCIS, <1cm, Stage 0, Grade 3, 0/2 nodes, ER-/PR- |
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rubybuttons… Joined: Nov 2008 Posts: 470 |
Nov 11, 2009 07:03 pm
rubybuttons wrote:
dmorgan, I don't recall much soreness afterward, although I probably had some hydrocodone or ibuprofen prescribed. There was some tightness near the incision I think. It was an hour long surgery tops. This was right before Christmas and I don't recall it affecting anything I needed to do. I probably had a lifting restriction though. Good luck with yours! Diagnosis: 10/15/2008, DCIS, Stage 0, Grade 3, 0/10 nodes, ER+ |
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adrienne2 Joined: Nov 2009 Posts: 32 |
Nov 11, 2009 07:55 pm
adrienne2 wrote:
Yesterday I had a lumpectomy for DCIS. I also had a sentinel node biopsy (2 nodes), just for safety. It was possibly done because my cancer, even though rated as intermediate grade, showed some comedo necrosis. A couple of hours before the surgery, they injected a radioactive tracer material. It was a little uncomfortable -- it burned a bit as it was injected -- but it was easily tolerated. During the process, the doctor said 1/3 done, 2/3 done, so I could tell that it was going to be over quickly. The whole process took just a few seconds. I figure I can put up with a few seconds of discomfort to save my life. Some blue dye was injected later, while I was in surgery. I was asleep, so I can't tell you what that was like I should tell you that a couple of hours before the injection, I took a Xanax (that I got from the Nurse) to relax me. It relaxed me enough that I took a nap Last night before bedtime I took one Oxycodone so I would sleep well. I haven't had any pain meds today, and I feel fine. I'm taking things easy today, although I did go for a short walk. For the most part, my breast hurts more than the armpit, because it is more likely to bounce when I move. The armpit hurts a little when I raise my arm, but part of that may be the tape that's holding the dressing. I'll find out tomorrow evening when I remove it. When I'm just sitting, neither the breast nor the armpit hurts. Best of luck with your procedure, and I hope you get good results. adrienne Diagnosis: 10/21/2009, DCIS, Grade 2, ER+/PR+ |
