Hi Marywj,

I must state first and foremost that I am not a doctor. As far as I know from my own experience of having a lumpectomy 12 years ago, followed by a double mastectomy the following year. First time I had 6 modes removed, which were fortunately all clear. Second time, my surgeon only wanted to take a maximum of 3, but didn’t get any, as he only managed to remove a lump of fat.

I understand that there are 20-30 lymph nodes in the axillae. People with enlarged lymph nodes may be considered for a sentinel lymph node biopsy The sentinel node is the first lymph node into which the tumour drains. As far as I know, if this is clear there is no need to take any more nodes away. If any cancer is found in this node, then further nodes may need to be removed and this is when an axillary lymph node dissection is carried out.

My surgeon explained to me that there are 3 levels of lymph node removal, but the more lymph nodes they remove, the more likely we are to develop side-effects. I already had lymphoedema in the first arm, where I had a level one removal and, this is why he didn’t want to remove any unnecessarily from the other axilla. The tracer injection is usually the blue dye. As far as I know, this covers the whole breast, so there shouldn't be any need for more than 1 injection.

Do you know when you are due to get your results back? Please keep in touch and let us know how you get on. We are always here for you.

Kind regards,

Jolamine xx

Hi Jolamine,

thanks for the reply.  Yes, I suppose they want to take as few as possible to prevent lymphodoema as you say (sorry to hear you had this).  I knew about the sentinel nodes being the first that the breast drains into, then there are more axillary nodes.  My understanding was that they take all the sentinel nodes.  Maybe I just had 1, not sure but I thought there were 3!

My surgeon (whilst amazing) isn't very forthcoming with information and I get the impression doesn't like to be questioned too much!  That leaves me with so many queries which I then have to take to my nurse!

I had the radioactive tracer injection before the op.  I think the blue dye is used during the operation if they can't get all the nodes with the radioactivity.  She definitely didn't use the blue dye.

im almost a week post mastectomy surgery and it seems to have gone well, very little pain.  I'm pretty obsessed that something will have been missed and that she didn't get everything  out!  I'm told they won't know full treatment plan until results next Wednesday, the 6th so that seems to be the last big hurdle.  I'm very worried.

Thank you again  M x

Hi Mary

I only had one node removed and my understanding is that the number of sentinel nodes vary between people. I had the dye and radioactive tracer with my lumpectomy as that was standatd practice  in my trust.

 I was told that a Sentinel Node Biopsy is recommended to be done even if lymph nodes look normal on ultrasound ( which mine did) to double check no sign of spread to lymph nodes so was happy to have it. My pathology report confirmed no sign in lymph nodes and clear margins on my 8mm IDC so good surgical result - also no evidence of lymphovascular spread in breast tissue. Also good

I did get a copy of my pathology report as like to double check these things so you might want to ask for yours. I've finished my treatment after 5 sessions of RT and on  anastrozole for 5 years

I am having a private consultation with a consultant oncologist to better understand my prognosis/ recurrance risk as my treatment was so quick I was never given the chance to ask for the level of detail I like. Having copies of reports/ MDT notes and clinic letters was needed for that. I was told I am low risk with a good prognosis but want a conversation to have some closure 

Hope that helps x

It does help Jolamine, thanks.  My nodes were clear on ultrasound.  I'm like you in that I like to see everything and ask questions, second opinions etc.  My feeling is that whilst we have to trust in the process, I feel the need to take some control back, read up and ask.  I will be asking for a copy of my pathology report as well.

I hope everything goes well in the future for you, I'm sure it will.   You're an inspiration and reading your experiences has been very helpful and reassuring for me.  Thank you so much. M x

Hi Dorestgirl,

Thanks for your reply.  I think my last message should have gone to Jolamine, sorry to both of you.

That's interesting that you only had one sentinel node removed too.  I've been worried about this in case there is anything in the ones she left in!!!!  My ultrasound was clear too but I doubt microscopic changes would show up on an ultrasound so I wanted all the sentinel nodes out!!!  Maybe I had only 1, just don't know.  
 

I get all my results next Wednesday so all I can do is hope for the best.  
 

Really pleased for you that your post op pathology was all good, that's brilliant news.  Wishing you all the best in your continued recovery.  Mary 

Hi Dorestgirl,

Thanks for your reply.  I think my last message should have gone to Jolamine, sorry to both of you.

That's interesting that you only had one sentinel node removed too.  I've been worried about this in case there is anything in the ones she left in!!!!  My ultrasound was clear too but I doubt microscopic changes would show up on an ultrasound so I wanted all the sentinel nodes out!!!  Maybe I had only 1, just don't know.  
 

I get all my results next Wednesday so all I can do is hope for the best.  
 

Really pleased for you that your post op pathology was all good, that's brilliant news.  Wishing you all the best in your continued recovery.  Mary