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Treatment

 
Treatment

Chapter: 6 - Treatment

Subchapter: 6 - Lymph Node Removal

In addition to your surgical procedure, your doctor may wish to remove and examine lymph nodes; this is to determine whether the cancer has spread and to what extent. Your doctor will perform a Sentinel Lymph Node Biopsy and/or an Axillary Node Dissection. Let’s discuss both methods.

Sentinel Lymph Nodes and Sentinel Node Biopsy
While it is not easily controlled, the spread of cancer is sometimes predictable. The cancer cells spread through a customary path, out from the tumor and into the surrounding lymph nodes, before they progress throughout the body.

To be able to identify the sentinel lymph node, the surgeon will inject dye or a radioactive tracer into the tissue near the tumor; the lymph nodes that are the most susceptible to the cancer’s spread will be marked by the dye or a radioactive tracer. During surgery, the lymph nodes will be removed and checked for the presence of cancer cells.

Axillary Node Dissection
To determine if the cancer has spread to the lymph nodes, examinations can be performed with ultrasound and more carefully by removing one or more of the first draining lymph nodes with sentinel lymph node biopsy. Patients with a tumor that has spread to these lymph nodes may require complete removal of the lymph nodes in the armpit, a procedure known as an axillary lymph node dissection. An axillary dissection is generally performed subsequent to a sentinel lymph node biopsy, unless a woman has had a positive fine needle aspirate of a lymph node.

A mastectomy or lumpectomy operation often includes a sentinel node biopsy and/or an axillary node dissection; both procedures involve a separate incision for lumpectomy patients. Following surgery, the pathologist will test the lymph nodes to determine whether the cancer has spread to the lymph nodes.

Lymphedema
Removing lymph nodes raises your risk for developing Lymphedema, a condition that may cause abnormal swelling of the arm, breast, axilla, or chest wall on the side of your cancer. Swelling up to one month after surgery is not unusual and does not indicate the presence of lymphedema. However, if you experience new or persistent swelling in these areas after one month has elapsed since your surgery, you should notify your doctor.

Related Questions

  • Teresa Klein Profile

    I go Friday for a biopsy on calcifications that were found. My Radiologist says they look suspicious. I'm so confused about it all.can it be cancer or not?

    Asked by anonymous

    Learning About Breast Cancer
    over 5 years 4 answers
    • View all 4 answers
    • Betti A Profile
      anonymous
      Survivor since 2013

      Microcalcifications can be -or+ depending on how they look on mammograms. They will only know what it is by doing a biopsy and having a pathologist look at the specimen(s). I've had what they call "benign" looking calcifications for several years but the ones in Dec.2012 looked "different" and...

      more

      Microcalcifications can be -or+ depending on how they look on mammograms. They will only know what it is by doing a biopsy and having a pathologist look at the specimen(s). I've had what they call "benign" looking calcifications for several years but the ones in Dec.2012 looked "different" and required a biopsy.

      3 comments
    • joan jones Profile
      anonymous
      Stage 0 Patient

      In 2004 I had microcalcifications and a stereotactic biopsy on the right and it came back negative .

      Have had yearly mammograms since 20o4 .
      May 2013 had routine mammogram and it showed microcalcifications on the right but in a different area . Had stereotactic biopsy which came back ductal ...

      more

      In 2004 I had microcalcifications and a stereotactic biopsy on the right and it came back negative .

      Have had yearly mammograms since 20o4 .
      May 2013 had routine mammogram and it showed microcalcifications on the right but in a different area . Had stereotactic biopsy which came back ductal carcinoma insitu - which is stage 0. Noninvasive !
      The earliest it can be and the best if the worst .
      Had lumpectomy and radiation which was all completed in September and am doing fine !
      I feel very fortunate !
      Best wishes to you on Friday and keep us posted - the waiting and not knowing are the hardest !
      Peace and calm !

      1 comment
  • Thumb avatar default

    I posted a few days ago about my sentinel node and lumpectomy. I had the surgery yesterday which took four hours instead of one and a half. The doctor found lymph node involvement. How does this affect my chance of survival?

    Asked by anonymous

    Stage 2A Patient
    almost 7 years 3 answers
    • Sharon Danielson Profile
      anonymous
      Survivor since 2007

      The same thing happened to me. I don't ponder my chance of survival because NO ONE can predict your life span. My surgery was 5 years ago, I am still alive, obviously, and try not worry. I leave the worrying up to my team of doctors. My job is to live the life I have to the fullest.... which...

      more

      The same thing happened to me. I don't ponder my chance of survival because NO ONE can predict your life span. My surgery was 5 years ago, I am still alive, obviously, and try not worry. I leave the worrying up to my team of doctors. My job is to live the life I have to the fullest.... which I am doing. Doctor's talk in percentages because that is how they set out your treatment plan. My doctor said even though I had a lymph node that was positive, it did not change my treatment plan at all. I went from a 2A to a 2B. Worrying about your demise is a destructive behavior. Focus on getting through your treatment, in the most positive way you can. Worrying, is not going to change anything anyway, it will just make you miserable. Again.... only God knows how long we have here.... there are plenty of women who have long outlived a "statistic". We are not numbers.... we are living, breathing, wonderful women! Positive thinking and affirming statements are what you need... not predictions of the end of your life. Hang in there, you will make it.
      Take care, Sharon

      2 comments
    • Thumb avatar default
      anonymous
      Survivor since 2012

      Hi, Please don't begin to worry about survival rates. You've begun the journey to good health and life. There will be soooo many factors to consider in the coming days that will determine your special plan and your doctors will guide you through each level of that treatment. Make a list of every...

      more

      Hi, Please don't begin to worry about survival rates. You've begun the journey to good health and life. There will be soooo many factors to consider in the coming days that will determine your special plan and your doctors will guide you through each level of that treatment. Make a list of every question-small, large, odd, and profound-they are eager to answer them and will be much more open if they see you're a patient hungry for info. You will be the most valuable partner in this quest to a rich and long life. Breathe and lean on those around you and be amazed at the strength that will carry you through ONE DAY AT A TIME. Hugs and waiting for you on the path to healing. :-D Jo

      Comment
  • Thumb avatar default

    The surgeon said he removed 25 lymph nodes and 10 were cancerous. Does this mean it has probably spread elsewhere? Are these numbers normal?

    Asked by anonymous

    Learning About Breast Cancer
    about 7 years 2 answers
    • Diana Foster Payne Profile
      anonymous
      Stage 4 Patient

      As Sharon said...every woman is different. I had 15 lymph nodes removed and 13 of those were cancerous. It doesn't necessarily mean that your cancer has traveled past the lymph nodes. Your dr. May want to do more testing to make sure. I had chemo before my surgery. Then had to have more...

      more

      As Sharon said...every woman is different. I had 15 lymph nodes removed and 13 of those were cancerous. It doesn't necessarily mean that your cancer has traveled past the lymph nodes. Your dr. May want to do more testing to make sure. I had chemo before my surgery. Then had to have more afterwards. When they found the positive nodes...some of them were "extranodal" meaning the cancer had broken outside some of the lymph nodes. That was the reason I needed more chemo. I'm going through radiation now. I'm also happy to say that my last PET scan showed no cancer!! Voice your concerns with our Dr. Yes, let us know how you are. Prayers to you. :)

      Comment
    • Sharon Danielson Profile
      anonymous
      Survivor since 2007

      It means it has spread from the original tumor. Your doctor will probably want additional testing of the type of tumor and the aggressiveness of the cells. I had 5 sentinal lymph nodes removed and one was positive for cancer. I hope you keep us posted as your treatment continues. We, on this...

      more

      It means it has spread from the original tumor. Your doctor will probably want additional testing of the type of tumor and the aggressiveness of the cells. I had 5 sentinal lymph nodes removed and one was positive for cancer. I hope you keep us posted as your treatment continues. We, on this board, want to support every woman who is going through this journey. All of our stories are different but we all care for each other.
      Take care, Sharon

      4 comments
  • Thumb avatar default

    Are you able to use your arm normally after an auxillary node dissection? Does it affect day to day life?

    Asked by anonymous

    Learning About Breast Cancer
    about 7 years 6 answers
    • View all 6 answers
    • Diana Foster Payne Profile
      anonymous
      Stage 4 Patient

      Hi Jayme, I had a lot of limited mobility in my right arm. I tried doing exercises at home to improve this but in the end I decided to go to a Physical Therapist. I've been seeing her for 2 months now and she has helped my tremendously!!! Before..I couldn't take my shirt off by myself. But now, I...

      more

      Hi Jayme, I had a lot of limited mobility in my right arm. I tried doing exercises at home to improve this but in the end I decided to go to a Physical Therapist. I've been seeing her for 2 months now and she has helped my tremendously!!! Before..I couldn't take my shirt off by myself. But now, I can...plus reach places I couldn't before. if you decide to go to one....I highly suggest someone that is experienced with working with women who've had mastectomies and specialize in soft tissue massage as well. She not only makes me do exercises.....she begins with doing massage in my restricted area. It's been a life saver for me since I'll be going back to work on the 4th of June. Hugs Jayme.

      Comment
    • Thumb avatar default
      anonymous
      Learning About Breast Cancer

      I had an auxiliary node dissection about 2 months ago. I was told to gradually stretch my arm with wall walks and not to lift anything over 10 pounds. Now I have pretty good mobility, but was told by a PT to stretch my arm more before I have radiation therapy (I'm in chemo therapy now). I do have...

      more

      I had an auxiliary node dissection about 2 months ago. I was told to gradually stretch my arm with wall walks and not to lift anything over 10 pounds. Now I have pretty good mobility, but was told by a PT to stretch my arm more before I have radiation therapy (I'm in chemo therapy now). I do have numbness in my armpit and back of my arm & am at risk for infection because of the lymph node removal & shouldn't have my blood pressure or blood drawn on that side forever. Hope this helps.

      1 comment

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