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Jan 2, 2010 07:58PM
, edited Jan 2, 2010 08:00PM
pagowens, there are several threads on these discussion boards about the radioisotope injections used for SNB. SNB is now standard procedure for women who are presumed to have early stage BC and have no clinical evidence of spread to the axillary nodes. So, pretty much any of us who had SNB had those darn injections.
I have to admit that I knew less about the SNB injections than I did about almost everything else related to my diagnosis and treatment. My BS (surgical onco) had told me there would be two types of injections -- a radioisotope and a blue dye. She said she would remove any nodes that were either radioactive or stained blue or both; and there would probably be (on average) 2 or 3 such nodes. I ended up having 3 "sentinel" nodes removed.
Because of the way they do things at the cancer center where I've been treated, I was given the radioisotope injections on the afternoon before my early morning surgery. The injections were done by a radiology tech in the nuclear medicine section of the hospital. She said there would be 3 injections (I think), and although the syringe contained a local anesthetic, they would "sting a little". But, as the first one went in, she said, "I mean, it will hurt A LOT." And, it did. I imagined someone was holding a lighted cigarette on my nipple. She immediately began to apologize ("Oh, I'm sorry. I'm so sorry -- I know this is hurting"); and she said the burning would quit "really soon." It did, after probably less than a minute (it seemed much longer). She rubbed my boob a little, to help move the radioactive stuff into the tissue.
I think that stuff would burn, no matter where they put it. The problem is, most of us got those injections in or near the areola, which is an exquisitely sensitive area of the body. It's full of nerve endings. So, should anyone be surprised, when it hurts???
The second stuff that was used as a marker was a fairly large volume (several ml) of a blue dye. It was injected after I was under anesthesia, which is standard procedure at that cancer center.
Given all the other painful and uncomfortable things that happened to me in the 6 months between my dx and the end of chemo, I would not rank that nuclear dye injection very high on the list. In the top 25%, maybe, but that's about it.
SNB has replaced full axillary node dissection as standard-of-care for clinically negative nodes, though. So it should not take long for surgeons and nuclear med folks to catch on and address the "discomfort" we're feeling. I hope so, anyway. (OTOH, we're still dealing with that pesky "discomfort" from the compression they use during a mammogram, aren't we?)
2008, IDC, Stage Ia, Grade 2, 0/3 nodes, ER+/PR-, HER2-