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Topic: Need for node dissection for diagnosis.

Forum: Lymphedema — Risks, tips for prevention, and info about products that can address the symptoms of lymphedema.

Posted on: Jun 2, 2006 04:58AM

sadinohio wrote:

I've been wondering if it is normal procedure in diagnosing any other type of cancer to risk completely messing up the patient's lymph node system. Does anyone know?

I had a friend with Hodgkin's disease which is cancer of the lymph nodes and she never had her lymph nodes removed to diagnose the condition.

Why do they have to do it for breast cancer? Seems the treatments we receive really mess us up in the name of a "cure". They cut us, nuke us, poison us and basically want to destroy everything that makes us female - hormones included.

On top of all that removing nodes just opens us up to another set of problems even if they wind up being negative for cancer.

I was diagnosed with DCIS in November and had surgery at that time - no nodes were taken, but my radiologist mentioned that maybe I would notice some swelling in my arm, but nothing serious. I was too naive to realize he was referring to lymphodema, but now that I'm thinking about it he probably was.

So now I have to worry about that along with everything else.

Just doesn't seem right. Log in to post a reply

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Jun 3, 2006 07:05AM rockongal wrote:

I guess they just want to see how invasive the breast cancer is, and for staging purposes. I agree that it's unfair! Hope you avoid LE b/c it can be dibillating (at least for me). Just watch it & get tx ASAP if you notice anything.
Kim
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Jun 3, 2006 07:48AM Binney4 wrote:

Hi there, sad Buckeye,
You're right -- nothing fair about the whole thing. Still -- we bc ladies are not alone. Nodes probably aren't taken for lymphoma because they already know the cancer is in the circulatory system -- just guessing there. I understand that nodes ARE often taken, though, with ovarian, uterine or cervical cancer and also with prostate cancer, all of which poses a risk for lymphedema (LE) of the lower limbs and abdomen. It does seem especially frustrating if they take nodes that turn out to be non-cancerous, but then you do for sure want to know it in case they are.

And it's probably true that your rads onc was referring to LE, though he should also have mentioned that bc treatment can cause LE of the breast or chest, back, or side (it's called truncal LE). Helpful prevention guidelines can be found at the National Lymphedema Network web site:
www.lymphnet.org .

But, yeah, I hear you -- one more stupid thing to have to worry about for the rest of our lives. As if bc weren't enough! The "But-aren't-you-just-so-glad-to-be-alive!" argument never holds much water with me, but at least do know that, should you develop the swelling of LE, there is treatment available (and it's NOT invasive!)

Stay well!
Binney
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Jun 3, 2006 07:48AM Anonymous wrote:

The lymph nodes are the "gateway" to the rest of the body. My nodes were taken first in a sentinel biopsy while I was having my lumpectomy. My cancer was known to be aggressive/invasive from the stereo. biopsy I'd had done, which indicated to my surgeon that he needed to check nodes. During the sentinel he took 7 nodes and 1 was positive. From that I had an axillary dissection which removed another 20 (approx.) -- all negative. Because 1 node was positive he also did scans and x-rays to see if it had travelled, and thankfully it had not. The cancer cells can travel through the lymph nodes to other organs/parts of the body. And true, it does mess up the body, and LE is then a possibility, but I'm happier knowing I had the nodes tested and if LE becomes part of my life, I can cope with that. It's a small price to pay to ensure that I'm doing everything I can to beat this disease over the head.

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Jun 3, 2006 05:09PM mstanton-2005Dec15 wrote:

I am new to lymphedema challenges and was wondering what is done if there is fluid or swelling of the breast or trunk!? I thought it was just the arm!! I am due to see a PT/OT due to cording under my armpit after a masectomy and auxillary disection (20 nodes out, 12 positive). Was also wondering if it is a GIVEN that the cancer has spread if this many nodes are positive. Is it possible the nodes trapped the cancer and stopped the spread. I have realized that the Doc's don't always have a definite answer but guess some of the time.
MJC
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Jun 3, 2006 10:22PM rhymeee wrote:

Where I live they do axillia node dissection for any breast issues that do not have a B9 pathology.

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Jun 4, 2006 12:04PM NPat wrote:

mjc,
My dear, you are not alone... I had 11/20+. Remember the number positive is just a NUMBER. They can't tell us how long we are going to live... they don't know. I gave God my nodes two years ago and He still has 'em. I figure He can handle them because I sure couldn't cure myself!

As far as swelling in the breast, back, shoulders... yes, this can happen... it is truncal lymphedema. I have it. It requires treatment just like LE anywhere else. If you had a lumpectomy, you may notice an enlargement of the breast and a "heaviness". The skin may tingle and appear red and warm. The skin may appear tight and tender. If you have any of these symptoms, you need to see a provider... hopefully, someone who recognizes LE. Obtain a referral to a CERTIFIED LE therapist for a thorough evaluation. You may also have a mastitis or infection which can be quite serious and requires antibiotic therapy.

rhymee, in my area they do more complete axillary dissections if the pathology is malignant because sentinal node biopsies are not done regularly and there is a skill to doing these properly. I was to have a SNB but my onc contacted my surgeon and pressed for a complete axillary dissection. He was afraid they would miss some positive nodes. Well, the 11 were completely replaced with malignant cells... so I guess they did the right thing even though I have LE.

Thanks for posting here! We hate to see new people joint the group but we love to support one another and you can't find a better group!

Pat
NPat

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