0/1 LN positive

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I recently had a lumpectomy for right breast 22 mm G3 IDC, with WLE + SNB + OSNA. Could you please confirm the significance of 0/1 LN positive. At first I thought it meant 0 = negative, but I think it means 1 LN has cancer cells? I should be grateful for any advice, please.

Unfortunately my lovely cancer team were unable to take more sentinel nodes away for testing during the procedure (there was a problem with the testing lab apparently), so they only removed one and tested this while I was still under anaesthesia. They were hoping at least 2-3 nodes could be assessed and if cancer was found more widely, they would have removed axillary nodes as a safeguard. Now I may need to go back in to have further surgery at a later time.

I am still hopeful that I will not need to go back for further surgery, but any advice you can give would be helpful. My lumpectomy was on 15th January and I will not be seeing my surgeon for at least two weeks.

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Hi @angelina Iā€™m not sure if I should butt in on a technical question for the nurses in case I confuse matters but as they wonā€™t be able to answer your question until at least Monday, I thought I would pass on that my histology report following a lumpectomy, in which two lymph nodes were taken, says: Right sentinel node : No metastasis (0/2). So your first thought might be correct. Hope so.

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Oh thank you so much for replying. I know I will have to wait for the nurses to reply. I thought about changing the category to make my question open to all - would have been better.

In the hospital I saw my breast cancer nurse before leaving and she said that my result was good, but then when I came home and googled (should never do this!) I saw

**A lymph node (LN) status of 0/1 positive means that at least one lymph node contains cancer. The number of positive lymph nodes is an important factor in determining a patientā€™s prognosis and treatment plan
**

I go back next week for a wound check and I will ask for confirmation of my interim result because I know when the full analysis is back, I may need to go back to have further surgery; so much hangs on that lumpectomy result. Thank you again for your support Tigress

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Hi Angelina,

Like Tigress I donā€™t want to step in on a technical question, but if it helps at all, my histopathology was 1/2. They took two nodes and 1 was positive, so 0/1 might mean there was no cancer in the one taken?

Not sure if different hospitals have different ways of recording but just thought Iā€™d share how mine was noted.

Best of luck! :blush:

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I had bilateral mastectomy and sentinel lymph nodes both sides and they were 0/3 on left and 0/1 on right - it meant none out of three nodes taken were positive on left and none out of one node taken on right were positive.
So all clear.

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Thank you Sharlou. I think I can be quietly optimistic after reading all these kind comments. I know my surgeon was disappointed not to get more than one node fully tested in the lab while I was in theatre, but even so with one sentinel node tested and presumably the first node clear, this might be a good sign.

The ā€œpositiveā€ after 0/1 LN confused me completely. Why couldnā€™t they have said one node tested, tested negative or something that we can all understand? Thank you so much for responding

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Lynn, that sounds really good news for me. Thank you. I hope nothing changes when my results come through and that they manage to get clear margins and I will not need to have further surgery in the near future. It is beginning to make sense now to me. Thank you for your help.

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I donā€™t know where you saw that quote online @angelina but if it was from a reputable site like MacMillan, Breast Cancer Now or Cancer Research, Iā€™d be surprised. I have to have surgery on my nether regions in February and looked up online (including I have to say some NHS RHA pamphlets) about recovery and convalescence and there was so much contradictory stuff out there I was quite shocked. In talking to the surgeon on Tuesday I asked ā€œshould I do thisā€™ or ā€˜should I do thatā€™ The answers were unequivocally NO, NO, DEFINITELY NOT! So donā€™t believe everything you see online.

I hope that you can have a slightly less stressful weekend. Good luck with your results meeting, Iā€™m sure that we will all keep our fingers crossed for no more surgery for you.

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I would agree with what others said, but see what nurses think. My results said 1/1 positive. I then had a clearance which said 2/15 positive. Iā€™d assume 0/1 means sentinel node is clear. Best person to ask is your breast care nurse or your surgeonā€™s secretary. Good luck with the rest of your treatment x

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bluesatsuma, thank you for your support.

I have just read ā€œUnderstanding your Pathology Resultsā€ Breast Cancer Now booklet, page 10, where it clearly states:

The pathology results will say how many lymph nodes were removed during surgery and how many contain breast cancer cells. For example, 2/10 means 2 out of the 10 lymph nodes removed had cancer cells inside them.

On that basis 0/1 LN positive result should mean no cancer was found in the 1 node tested. That would certainly be good news although I am not completely reassured that all my lymph nodes are clear. This now becomes the important question for my team. Can we be reassured that my lymph nodes are all cancer free on the basis of testing just one Sentinel node? I do have doubts and I know my team do as well.

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The nurses will hopefully answer your question on Monday but it may put your mind at rest to phone on 0808 800 6000 between 9-4. Mention you have posted a question online.

:smiling_face_with_three_hearts:

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Thank you naughty_boob. I am not worrying about this, just feeling a bit confused. You have all been so helpful and have already given sensible advice. I am happy to wait until tomorrow when I will be able to speak to my own breast cancer team as well. I know I have a caring team and I am lucky to have them.

It was unfortunate that just before going into theatre on the 15th January, my consultant came out to tell me (I think) that the testing laboratory was unable to process ?three Sentinel Nodes while I was actually having my lumpectomy procedure. This was apparently the plan and if any of the ?three nodes were found to be positive while I was under sedation, I would likely have had a full axillary clearance at the same time as my procedure to avoid having a second surgery. My original consent for my lumpectomy surgery on the 10th December was based I believe on having several sentinel nodes removed at the same time for analysis as my lumpectomy. On the 15th January, I recall I had to consent again just prior to the procedure, as a result of the sudden change in plan. At the time, I thought nothing of it. There was so much buzzing in my head.

Based on 0/1 LN, it appears that only one node was removed/biopsied, but perhaps I am mistaken. Even if the laboratory was unable to test three nodes right away, I would have thought that more nodes would still have been removed during surgery for testing at a later time, but perhaps this did happen or perhaps biopsies were taken by the surgical team. This is what is now unclear, but it helps to write all this down and to discuss my thoughts with you all so that tomorrow I am able to absorb more of what I might be told by my breast cancer team.

Thank you all again. It does help to talk

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Hi angelina

Thanks for posting on our forum

We hope to be able to respond to you tomorrow.

In the meantime our helpline is open from 9am tomorrow.

If you do phone our helpline please let us know that you have asked a question on our forum so that we know your query has been answered. Thank you

With best wishes.

Lisa

Ask Our Nurses service co-ordinator

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Hello angelina

Thank you for your post.

The layout and terms used in pathology reports may vary from hospital to hospital and it can be confusing.

Generally, 0/1 LN on a report means that one lymph node has been removed and was found to be clear of cancer cells as @Tigress, @sharlou, @lynnc123 and @bluesatsuma have discussed and as our booklet explains on page 18. As you say, when you go for your wound check,youā€™ll hopefully be able to clarify this with your treatment team.

One of the reasons for having an one-step nucleic acid amplification(OSNA) during surgery is to assess the lymph nodes at the time, as the surgeon gets the initial results during your operation. If a pathologist found that a lymph node had cancer cells in it, your surgeon may then have taken more nodes at the time. Assessing the nodes at the time of the operation might avoid having a second operation to the lymph nodes.

We offer a range of free supportive services for anyone who has had a diagnosis of breast cancer which you may be interested in. They include face to face and online courses and events

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Rosey

Breast Care Nurse

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