Log in to post a reply
Nov 5, 2020 01:12AM
Cherisse, please go to your "dashboard" for instructions as to how to fill in your diagnosis, surgeries, & treatments--then post it as a "sig file" aka "sig line" which will appear at the bottom of your posts. We can't give you informed advice without getting the full picture.
The whole reason for a sentinel node biopsy is that those are the first lymph nodes to which cancer would spread should it (hypothetically) spread. Hence the term "sentinel." Back in the day decades ago, they'd take the entire first level of axillary nodes, sometimes all the axillary nodes, without knowing their status (they used to cut first and ask questions later). Taking the sentinels for biopsy is the only way to know for sure if they're negative for cancer. It's much less invasive--and if 0-3 are positive, no need to dig beyond them. As Beaverntx says, you have dozens more nodes remaining to do their jobs.
Not at all unusual to need a re-excision to get clear margins. (The latest definition of "clear" is "no tumor on ink*," so much less tissue needs to get removed on that second pass). I went "under" at about 1:30 pm, and "came to" in the recovery room about 4. Even though lumpectomy is less invasive than mastectomy and is outpatient surgery, it still has to be done under general anesthesia (not just the "conscious sedation" such as propofol you get for, say, a colonoscopy) because you have to be perfectly still for the duration. That includes a powerful muscle relaxant injection and intubation.
Needing a re-excision is NOT a slam against the skill of your surgeon. It's not always possible (in fact, usually impossible) to determine margins with the naked eye while you're on the table during surgery, and the only way to know for sure they got it all is by post-op biopsy by a pathologist. Those "leftover" cells are not visible except via a microscope.
And it also doesn't mean those straggler cells are going to metastasize. Breast cancer doesn't spread that fast.
*"Ink?" They use a surgical marker to draw the boundaries of the tumor and surrounding tissue to remove. Used to be a margin wasn't "clear" unless there was at least 2-4mm between the marker line and any tumor cells. Now (beginning in 2017) so long as there are no tumor cells touching that marker line, the margins are considered clear. But some surgeons are still kickin' it old-school.
Diagnosed at 64 on routine annual mammo, no lump. OncotypeDX 16. I cried because I had no shoes...but then again, I won’t get blisters....
9/9/2015, IDC, Right, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- (IHC)
9/23/2015 Lumpectomy: Right
11/2/2015 3DCRT: Breast
12/31/2015 Femara (letrozole)