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Topic: Lab can't find lympnodes in removed tissue

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AZ
Joined: Apr 2008
Posts: 8
  • Posted on: May 12, 2008 03:06 pm
Debinaz wrote:

Has anyone had this happen??? If so what did your surgeon or oncologist recommend. I had my mastectomy 04/16/08 I had Sentinel Node Mapping done right before surgery. The doctor felt like he removed a large chunk of tissue from the area, however when sent to the lab they can't seem to find the nodes because I had scar tissue from implants put in 8 years earlier. At this point no one seems to know what to due next. I see the oncologist next week and they will order the oncotype DX test. Has anyone had this experience? How will I know if there was any spread without being able to have the lympnodes tested????

Deb in AZ

Posts 1 - 6 (6 total)
otter
AL
Joined: Jan 2008
Posts: 2402
May 12, 2008 03:29 pm otter wrote:

Deb,

I think sometimes the sentinel node procedure fails because the lymphatic drainage is messed up from previous surgery.  Some surgeons won't even do SNB if there has already been reconstruction or a lumpectomy on that side.  Even if there hasn't been previous surgery or scarring, occasionally the SNB procedure does not highlight a LN.

If your surgeon removed "a large chunk of tissue from the area" rather than taking one or two nodes that were labeled with dye, it sounds like he already knew there was something wrong.  According to my breast surgeon, if she had been unable to identify a sentinel node during my mast/SNB, she would have done a full axillary node dissection (ALND) at that time.  When the sentinel node can't be located, that's the only way to find out for sure if the cancer has spread.  ALND involves removal of all the nodes from under the arm.  There should be anywhere from a dozen to maybe 30 nodes in that pad of tissue they take out.

otter 


Dx 1/14/2008, IDC, 1cm, Stage I, Grade 2, 0/3 nodes, ER+/PR-, HER2-
AnneW
Boulder, CO
Joined: Oct 2002
Posts: 2117
May 12, 2008 10:49 pm AnneW wrote:

That's interseting. You can visualize the nodes in the axillary tissue. Maybe yours are anatomically in a different spot? Deeper, perhaps?

I'm sure it's a conundrum for your surgeon. The oncologist is really going to want to know about those nodes!

Anne

2002 IDC stage 1, grade 1, rads & AI
Dx 9/18/2007, ILC, <1cm, Stage I, Grade 1, 0/1 nodes, ER+/PR+, HER2-
roseg
DC Area
Joined: Sep 2004
Posts: 7679
May 13, 2008 10:51 am roseg wrote:

Years ago my mother had surgery for DCIS. At the time there wasn't a good standard about lymph node and DCIS.  Like daughter, like mother - she didn't want to have any removed because of the possibility of lymphedema.

Her surgeon told her that during the surgery he felt around, but didn't find any enlarged nodes, so he didn't take any and she didn't need to worry.

This was more than 20 years ago!

So, my point is that while you may end up with a full node dissection, the fact that he took a chunk of tissue and none were enlarged would seem to bode well for little node involvement. 

Rose
Debinaz
AZ
Joined: Apr 2008
Posts: 8
May 13, 2008 04:07 pm Debinaz wrote:

Rose,

Thank You, I really needed a dose of positive additude right about now. I guess it's the old "No News Is Good News"

Deb in AZ

Linda1
MI
Joined: Oct 2007
Posts: 201
May 13, 2008 04:39 pm Linda1 wrote:

Deb, if necessary, they can always go back in and take some lymph nodes in a separate surgery.  I had a mastectomy w. SNB in June, 2008.  The various pathologists who looked at the nodes felt the results weren't clear, so the oncologist recommended a lymph node excision to take more nodes.  It wasn't necessary for the surgeon to take all of them, so she didn't....just a good enough sample to make the results clear.  Of course, if you can avoid that, it's better because of the risk of lymphedema, but if the oncologist suggests it, it is quite do-able.  Not as "simple" as a biopsy, but way easier to handle than the mastectomy.

Hope all goes well for you!

Linda


Dx 4/3/2007, DCIS, 1cm, Stage 0, Grade 2, 2/13 nodes, ER+, HER2-
Debinaz
AZ
Joined: Apr 2008
Posts: 8
May 15, 2008 05:06 pm Debinaz wrote:

Thank You all for your thoughts on my situation. It has helped me so much to have this site to come to for support.

God Bless You All!!!!

Deb In AZ

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