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May 18, 2019 08:00AM
hi Meow! I don't know why it failed. My breast surgeon never once told me that it could fail. That was in 2003. I had a 1 cm IDC. Sentinel node biopsy was rather new at the time and when it failed, for whatever reason, my breast surgeon reverted to the gold standard which was removal of the entire fat pad. Mine contained 24 nodes. I immediately got lymphedema in my left arm.
My medical oncologist at the time, whom I really liked, told me that when the pathologist removes the fat pad, they just cut the many nodes in half and check for cancer. He said there is a much more thorough examination of sentinel nodes because there are only a few to look at. He told me that even though my nodes were found by the pathologist to be negative, that cancer could have been present but missed.
From what I read since, the hardness of the lymph node, makes me think that a pathologist has a suspicion even before examining the sample whether or not it is cancerous. Even so, they can't be sure until they look at it under a microscope. Again, that is just my feeling, I don't really know. 2003, while almost 20 years ago, seems like a life time ago. So much has changed. I had chemo because I was pre menopausal at the time and my cancer was a cm. Back then, there was no OncotypeDx test. If the tumor was over a cm they recommended chemo.
Again, I am annoyed at my BS that did my recent mastectomy because when I asked the question about my node status, he just said to be sure to tell my MO that no nodes were removed. I only saw my MO once so far, but will see her again in June. I don't remember if I even mentioned that to her. Since I went to a cancer hospital, not just a hospital with a cancer unit, I thought things like that would be in my report and that they would be highlighted somehow for the other doctors in the team to be aware of. I guess I expected too much.
I am cancelling my appointment in July with the BS because, while he is a top rated surgeon and very nice to talk to, he completely dismissed my desire for a bilateral mastectomy and I felt pressured by him to do things his way. Also, I know when I had breast cancer the first time I only had to follow up with either the MO or BS, not both. I really like my MO even though I only saw her once so far, and I am still doing follow ups with my PS, or should I say, the PA from that dept. I don't know how much longer he will want to see me for follow up visits, but since I had problems with wound healing, I will keep seeing him until I am completely healed.
Again, I know there are other nodes in the area of the breast, but I don't know where the cancer would travel if there were no nodes in the arm pit?
The first time I had IDC, this time it was ILC and while not a lot larger, only 1.4cm, I am more concerned this time. They also found areas of LCIS in the mastectomy tissues.
6/6/2003, IDC, Left, 1cm, Stage IA, Grade 1, 0/24 nodes, ER+/PR+
12/4/2018, ILC, Left, 1cm, Grade 2, ER+/PR+, HER2- (FISH)