Breast cancer and sentinel lymph node

I had surgery last week for bc and lumpectomy. I was expecting a Sentinel node biopsy with radio active tracer but was told on the morning that there were no staff to do this and that the surgeon would inject blue dye during the op. Should I be worried about this. I now see that the use of both is common as it shows the lymph nodes accurately that need to be tested . If only blue dye used how can I be sure all taken out that need to be .can anyone advise. 
I didn't see the surgeon after the op so have no idea how many lymph nodes were taken or what was done - still have dressing on .My anxiety levels are going through the roof now.

  • Hi Nims 

    well done you have had your operation and it's gone well so happy it's all away for you .

    I had that same operation last July , I went the same morning to a different hospital for the dye to be inserted had a scan to do this , and had arrows drawn on my body , I could see the blue dye around the area for a few weeks after .

    I would imagine that they could do this when you were in theatres I'm sure they would not take any risks by not doing this for you , my first operation they removed 4 sentil nodes unfortunately for me one came back positive so I then the following week had to have full lymph node clearance they removed 29 nodes in a seperate operation thankfully these were all clear .

    I no the time from op to getting results are absolutely horrendous I was in a terrible state I kept busy busy .

    im sure if you call your breast cancer nurse she could check your notes and explain this thoroughly to you as I would have been the same you need answers or your mind will naturally wander but I'm sure they would have done what should have been done .

    good luck love Lara ️

  •  

    Hi Nims,

    I am sorry to hear of your concern following your lumpectomy. I have had 2 bouts of breast cancer in the past 13 years. I had the blue dye injected and 6 lymph nodes removed the first time. Your surgeon will have sent the tissue s/he removed, including your lymph nodes, away to Pathology. These are the results that you are currently waitig for post-surgery.

    When they come back, your surgeon will discuss the findings with you and will be able to answer any questions you have about your operation. If it is found that any of the lymph nodes are affected, s/he will arrange to remove the rest, to ensure that nothing is left behind. Pathology will also check that your surgeon has achieved an adequate margin around the tumour. in order to ensure that it has all been taken away.

    Have you been told when to expect 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

  • I have to wait 6 weeks for the results . I suppose I am not focusing on the results yet but am the op. So the next few weeks will be awful in terms of the wait. Now thinking the blue dye alone is not accurate otherwise why would I have a sentinel node biopsy appointment before surgery if it was then not done . How do iknow all have been taken out. How do I know they took the right nodes for testing. Is it accurate. What if they missed something . Anxiety in the early hours of the morning again .

  • Nims 

    honestly I would of had the same worry as you , it would have been good if your consultant had came to see you after your operation , I saw my consultant next morning and she explained everything to me and that gave me peace of mind of how things went .

    I would call your team and ask for a call back from your consultant explaining your worries and concerns 6 weeks is way to long to go on like you are where as a 5 min call could settle you I'm sure this has happened before and they have a plan b in surgery and do all they can but until you are told this by the professionals your mind will wander it's natural. 
     Hope you get a callback soon

    Lara ️

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    Hi Nims,

    I fear that you are overthinking things. Consultants wouldn't use the blue dye if it wasn't accurate. As far as I understand, the injection that you received before surgery was either a small amount of radio-active material and/or blue dye. This is to help identify the first lymph node, which is called the sentinel node. This will be taken up by your lymphatic system and will identify the sentinel node. This is removed and sent to pathology, along with the tissue removed after your lumpectomy.

    If cancer is found, in the sentinel node, then further nodes will be removed at a later stage. Your Care Team really do dot the i's and cross the t's when they're dealing with cancer - they don't leave anything to chance. Please try to convince yourself that they are on your side in this and you do need to have some faith in them. They are dealing with this sort of situation daily and will leave no stone unturned to get you cancer free.

    I know that this is an anxious wait. Try to kee yourself preoccupied, as this will help the time to pass. Many of us find the early hours of the morning the worst time, as there is nothing else to take our minds off the procedure and this allows our imaginations to run riot.

    Kind regards,

    Jolamine xx

  • Thanks Jolamine . I struggle to sleep and yes my mind does run riot at night .Your reassuring words help     My mum died of metastatic breast cancer ten years ago this year. She had cancer in 2001 and it came back in 2012. So I guess I worry that they might not  have taken it all .  She had a lumpectomy and it came back in her bones 11 years later and spread to her liver and brain  I know it's probably stupid and like you say they don't take any chances but I am reading stuff into anything . I think because I am scared .

    . I was scheduled to have a tracer an hour before the op to identify sentinel lymph nodes but they didn't do that as apparently they had no staff available. It sent me into a panic and I was told they would do something different . The blue dye had been mentioned by the consulatant at my diagnosis appointment but I never took stuff in properly. I think they normally do the tracer with the dye but in my case I just got the dye . I know I got the dye as my urine turned blue for a few days after the op . I didn't get to see the surgeon or anyone afterwards to tell me what they had done. I was told when I arrived at 7 am that my op would be in the morning and I would be second and I was told I would go down at 10 but then was  told it would be the afternoon . I did see the consulatant surgeon on the day of the op but not sure she did the op as the discharge note has someone else name on it . I rang the hospital today but my breast care nurse is on holiday this week . I have an appointment this week to get my dressing taken of so will ask then about what happened. 
     
    I just keep thinking if  I only had one of the procedures to identify lymph nodes and not both then they could have missed something . Why did they schedule two identification processes for the lymph nodes ? Is that because using two together is more accurate than one and if I only had one method ie the dye then could they have missed something .It's eating away at me as I do keep thinking about what happened to my mum. In my head I think they missed cells when my my mum was diagnosed otherwise why would it comeback .

  •  

    Hi Nims,

    I lost my mum to metatastic breast cancer 25 years ago too. It had spread to her bones, brain, liver and lungs, 12 years after she had her primary diagnosis. Like you, I was scared stiff when I was waiting for a diagnosis. Fortunately, diagnosis, treatments and after care have all improved tremendously in the interim. There has been just no comparison between the care that we have both experienced.

    Don't get your hopes up for getting many answers this week. The chances are that you'll only see a nurse, who may not know much about your surgery. However, it's still worth asking.

    If there is a cancer present, checking the lymph nodes ensures whether or not there is any spread of the disease. The other important factor is to ensure that all of the tumour is completely removed. This is why the tissue removed is sent to pathology, to check that the surgeon has not only removed the tumour, but a set margin of healthy tissue too. Cancer is a growth. If it isn't all successfully removed, chances are that it will continue to grow and eventually spread to other organs. Even if all tissue sent to pathology is as it should be. This only states that it is good at the time that the samples were taken.

    Sometimes people deveop another primary. This can be in the same or another organ. I developed a second primary in the same breast, a year after my lumpectomy and had to have a double mastectomy. There really are no guarantees that a new cancer doesn't form, or that an existing one doesn't spread. Some cancers are more aggressive than others and are more likely to spread. Surgeons do their best to prevent this from happening, but they can only do so much. 

    One thing that anyone who has had a cancer diagnosis is always afraid of, is the possibility of recurrence, but this is something that we all have to learn to come to terms with.

    I hope that your're healing well now and beginning to feel more comfortable.

    Kind regards,

    Jolamine xx

  • Thanks Jolamine. So sorry to hear about your mum .  It was hard watching my mum going through her cancer recurrence but as you say medicine has moved on even within those 10 years.

    I am worried about just getting the dye during the op and not before as I was expecting but there is little I can do about it and worrying isn't going to help I know. But it doesn't stop me worrying . I have a follow up appointment now for mid March to get my results .it's a telephone appointment but you can request face to face . I  worry that not all the nodes will be picked up properly .ie that there will be a node that they missed because I wasn't given he tracer as I was told I would be . The consultant surgeon that did the op is not the same as the one I met at the diagnosis appointment - I got a cancellation appointment

    .I am over thinking stuff I know and what you say is true that no one actually knows whether another primary will come back ( as happened with you ) or whether could spread . 

  • Hello, I had a lumpectomy and sentinel lymph node biopsy December last year. The blue dye was inserted whilst I was in Theatre having surgery. 

    I still have a blue boob, apparently it takes time to disappear. I did also have a scout tag inserted a few days before my op. That enabled the surgeon to locate the tumours that needed removing. I had a low Oncotype score so don't need chemo. I'm having 5 sessions of radiotherapy soon and have just been put on Letrozole by my Oncologist. 
     

    Try not to worry too much, you will be well looked after on your journey xx 

     

     

     

  • Hi Nims,

    Surgeons tend to go for the sentinel node, as they know that if it's not infected, then the cancer can't have spread. They don't take too many nodes away, because if they do, you are more likely to suffer from lymphoedema later on. I have this and it's not much fun! You are certainly overthinking things, but why not phone the nurses on this site, if only to put your mind to rest? You can reach them on 008 800 4040, from 9.00am - 5.00pm, Mon - Fri. it is a long time to wait until mid March, when you still feel uncertain.

    I suspect that like me, you are terrified, having seen how hard it was for your mum at the end. My mum's treatment still gives me nightmares! 

    Kind regards,

    Jolamine xx