Topic: Pathology- intramammary lymph node

Hi KristyAnn, the surgery is now behind you. focus your thoughts on healing and prparing for chemo. Think of the chemo as your helper in this and you may be able to look forward to it, kind of... The chemo will be over before you know it, really.

I had my lumpectomy and sentinal node biopsy on Apr 28 and just found out that my margins were clear and the two lymph nodes removed were negative.  But there was an intramammary lymph node found with the tumor.  So, now what?  Even the docs were confused as this is not a common occurance.  They basically are telling me not to have more lymph nodes removed since the 2 were negative.  They are not recommending a mastectomy though I wonder if I should have one.  They are recommending a stronger chemo treatment than they originally planned ( I am triple negative ).

Does anyone have any other info on a postive intramammy lymph node with negative regular lymph nodes?

Thanks!

In my case, two sentinel nodes showed positive for micromets.  Another one did too. This third node wasn't a sentinel node but was harvested in the process. I've often wondered whether this node was technically an 'intramammary node'. I went on to a full axillary node dissection (all 14 negative) and adjuvant chemo (4 carboplatin). I'm seven months out of chemo and often hopeful that I'll be okay.

I think it's the same thing Mar.  I had full breast radiation (28 of 'em) and 8 boost to the tumor bed.

Kristy I had a positive intramammary lymph node.  On my original Ultra sound, they thought there was another mass on top of the palpable tumor.  During surgery, it turns out is was a ILN that was cancerous.  My sentinal node had micromets of .15 (it would've had to be a 2.0) to be considered a positive node.

I was treated like you- as stage two cancer, grade three weakly ER +, her2+++.

I did dose dense chemp- 4 ac followed by 4 Taxol-- then I had reconstruction, and then I went on to do a year of herceptin.

I am approaching my 4 years anniversary this summer. 

I don't think you should get overly concerned about the ILN. You got clear margins with surgery, and now are on to the next phase of your tx.

What's your next step?

KristyAnn,

I choose to delete my post on radiation of the internal mammary lymph node as your positive finding was on an "intramammary" lymph node, or one that I take it was located in the breast tissue, similar to BethNY.

Internal mammary lymph nodes are a chain which run generally along the breast bone, and for which radiation is often given too. If included in post lumpectomy radiation, the radiation oncologists use CT guidance and plan the delivery a tad differently than they do when planning total breast radiation post lumpectomy.

Just wished to clarify this. Good wishes being sent your way.
Tender

I have TCH number 4 (out of 6 total) tomorrow so I am making progress. I will ask in 3 weeks when my onc returns (she is on vacation today) about rads- there was some uncertainty whether I would have radiation since my SNB was negative BUT I declined to have the axillary dissection. My onc and surgeon disagreed on the ALD and I got a third opinion who felt that my biggest risk was not the axillary nodes but that cells had escaped the breast and felt that chemo ASAP was the best way to reduce my risk- so I went with that opinion (it matched the surgeon) - its just such a scary situation when two highly qualified doctors cant agree and leave me to make the final decision!

Kristy