Posted on: Apr 23, 2015 01:36PM - edited May 28, 2015 11:16AM by NATSGSG
I came across this wonderful article that discusses in details all about the lymphatic system and lymph nodes, its functions & importance. So I'm copying and pasting it here. The original link for this article is at the bottom. I hope these info will help you make your decision with regards sentinel and axillary lymph nodes later, and while you are waiting for your results before surgery... Please take care and I wish you the best of everything. We're here for you. @!@
Living without Lymph Nodes1 (FY901) / M.C. Monroe, K. Roberts, and B.F. Shea2 / Publication #FCS8831
Axillary (under the arm) lymph nodes are often used in the diagnosis and treatment of breast cancer. This fact sheet helps women understand why lymph nodes are important and why sometimes it is necessary to sacrifice them. In addition, we make recommendations regarding measures women can take to prevent or minimize both infection and a condition called lymphedema, which can occur when axillary lymph nodes are removed during surgery for breast cancer.What are lymph nodes?
Your body has three circulatory systems. One is the arterial system that brings oxygen and nutrients to all the tissues in the body. The other two circulatory systems—the venous system and the lymphatic system—remove waste products from the tissues. The arterial and venous systems are powered by your heart. The lymphatic system does not have such a pump. Instead, the action of muscles in your arms and legs helps move fluid and cells through lymph channels.
The venous system removes 90% of the waste products from the tissues (mostly water). The lymphatic system removes the remainder, mostly protein molecules, bacteria, and cancer cells. Through its channels and lymph nodes, the lymphatic system is able to accommodate large molecules that don't fit within the venous system. Lymph nodes exist in various parts of your body, including the armpits (axilla), the groin, and the neck. Once lymph fluid reaches the lymph nodes, it is filtered and treated. The lymphatic system is part of the body's immune system and foreign cells that arrive in the lymph nodes are attacked by immune system cells. After the lymph fluid is concentrated within the lymph nodes, it is filtered into the bloodstream where the kidneys capture the waste material and pass it over to the bladder.
You can see your lymphatic system working when you see swelling go down around an injury. Injured tissues produce excess fluid as part of the body's response to injury and then the lymphatic system pulls fluid out of the injured area, causing the swelling to go down.What is the connection between lymph nodes and breast cancer?
The axillary lymph nodes are the ones that are most likely to drain the area of your breast that has a tumor, even though there are other lymph nodes both in your breast and closer to your breastbone. If the tumor has sloughed off waste cancer cells, the axillary lymph nodes have probably collected them. Testing these lymph nodes for cancer is one way to determine how aggressive the tumor is and whether the cancer cells have begun to travel to other parts of the body.
There are approximately 20 lymph nodes in two clumps in each armpit. Half of them are called Level 1 (the easiest to get to) and the other group is called Level 2. There are additional lymph nodes under the collarbone, and more on either side of the breastbone, but these are rarely removed in surgery.
Unfortunately, surgeons can't remove lymph nodes, test them for cancer, and put back the ones that do not have traces of cancer. In fact, they usually can't even see lymph nodes because they are so small. Surgeons usually remove a clump of fatty tissue that is likely to contain lymph nodes and have pathologists look for lymph nodes within the tissue. If they find them, the nodes are tested for cancer. A report of "three out of nine nodes positive" means nine nodes were found and three were positive for cancer.
Because lymph nodes are important to retain for a healthy life, surgeons are cautious about removing too many. A relatively new technique called a sentinel node biopsy is being used on select breast cancer patients to reduce the number of lymph nodes removed. Doctors use a radioactive dye to identify the lymph node that is the first one downstream from the tumor. They remove this one node during surgery and test it for cancer right away. If the biopsy is positive (cancer cells are present), more nodes are removed in the same operation; if it is negative, the surgeon may decide not to remove more nodes.
Knowing the status of some lymph nodes does not give you proof of the status of other lymph nodes, but the chances are that if the first ones tested are cancer-free, the others are too. Still, testing lymph nodes for cancer is not a fool-proof method for predicting whether breast cancer will metastasize (leave the breast) in the future. In about 30% of cases, women with no positive lymph nodes will have a recurrence of breast cancer some years later. The information lymph nodes provide is not perfect.
When radiation treatment is used following surgery, lymph nodes not removed during surgery are often included in the radiation field since they may contain cancer cells. Radiation treatment may scar muscle and skin tissues making it difficult for the lymphatic system to function.
Living with a damaged lymphatic system
We have seen that two common treatments for breast cancer significantly impair the lymphatic system: surgery to remove lymph nodes, and radiation to the armpit, shoulder, breast, and chest wall. But what are the effects of these treatments on this important part of our circulatory system?
When any part of the lymphatic system is damaged, fluid can back up, resulting in swelling. This swelling is called lymphedema. Left untreated, the area can become stiff and painful with burning sensations from the protein-rich fluid. Stiffness in the tissues can lead to a constriction of the lymph channels, which results in more swelling. Swollen tissue can tax the lymph vessels causing them to dilate, leak, and become inefficient. The affected area (usually the arm, hand, or chest) may become so swollen that movement becomes difficult. Treating the swelling as soon as possible will decrease the chances of further damage.
There is no foolproof way to prevent lymphedema from developing when lymph nodes have been removed, but there are some things women can do to minimize their risk. Women who have problems with lymphedema often remember activities or events that may have contributed to the onset of swelling. Avoiding this set of activities is all we have in the way of advice for reducing risk for lymphedema. The commonality among these activities is that they all restrict lymph fluid movement or tax the lymphatic system (see list below). The bottom line is that women with impaired lymph systems should try to avoid anything that might create an additional burden to fluid channels.
The following activities place the lymphatic system under stress:
None of these risk factors is guaranteed to cause lymphedema. Women who have had axillary nodes removed or radiated must cautiously try the activities that are most important to them and ascertain whether or not their body will react with lymphedema. When it is possible to avoid taxing the lymph system, doctors would advise it. For activities that are unavoidable, women can wear a compression sleeve and/or have the arm wrapped with an elastic, bandage-like wrap. Both the sleeve and the wrapping assist the muscles in moving lymph, improve drainage of fluid from the affected arm, and slow the amount of new fluid flowing into the area.If you have lymphedema
Lymphedema is diagnosed based on one symptom: swelling. Measurements are taken of the circumference of the arm every four centimeters from the wrist to the shoulder. Early measurements can be compared to later measurements of the same arm, or the affected arm can be compared to the unaffected arm. A change of 1½–2 centimeters (cm)—less than one inch in circumference—is usually interpreted as lymphedema.
If you notice that your chest, arm, or hand is larger than it used to be, or feels fuller or stiffer, seek medical attention immediately. There are several ways to help reduce the swelling and keep it under control.
The first goal of all lymphedema treatments is to reduce swelling, and the second is to maintain a healthy lymph system. It is better to prevent lymphedema, but this is not always possible. Living without lymph nodes requires a careful mindfulness to everyday activities. Something as simple as changing the shoulder you carry a purse on, to remembering to put gloves on when gardening may help you avoid problems in the future.
In the context of breast cancer, lymph nodes may seem to be a relatively small and inconsequential concern. In preparing for a long and healthy life, however, lymph nodes are an important consideration. Ask your doctor and other knowledgeable individuals for tips on how to live your life in good health.
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Apr 23, 2015 06:00PM Jeeper4 wrote:
Thank you for posting this! Very informative--I did not receive info on exercises after surgery, care with cuts, use of gardening gloves, carrying purse on the other side, etc. An oz of prevention...
Apr 25, 2015 03:01AM NATSGSG wrote:
You're all very welcome.......I learned from other's threads too...it makes me more aware of some things, and also what many others like me are looking for if we couldn't find it...so it makes me happy I can share any useful info...Take care and have a terrific journey towards recovery..@~@
Mar 24, 2019 12:40PM Mavericksmom wrote:
I had 24 nodes removed with my first cancer because the sentinel node couldn't be identified. (first tier fat pad removed and it contained the 24 nodes) All were reported to be negative, but my MO said that wasn't an absolute because they only cut in half when they have the whole pad and there could be cancer in the node that isn't seen. He said when they do sentinel node biopsies, each node is sliced many times. Not sure if that is correct or not, but that is what he told me.
15 1/2 years later, after mastectomy, no nodes were removed because they were the first time.
Can someone get a distal recurrence from a 1.3 cm ILC after mastectomy under those conditions? I don't see how.
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