I think the reason for the cancer skipping the sentinels and reaching a node beyond them is probably due to the finger like web that lobular is, not an ever-widening lump but a sinuous, weaving growth that may deviate away from the sentinel nodes in its spread. Nobody even mentioned to me I had lobular breast cancer … seriously. I only spotted it noted when I requested sight of my lab pathology report, post surgery. So no discussion or explanation around that at all, never mind about why only a non-sentinel node was affected. Only one found, at any rate … following tissue examination post axillary clearance (which was my choice, rather than just blindly zapping the vicinity of the tumour in hope, although I did go on to have left chest wall radiotherapy). However, worryingly, that node had extracapsular spread, meaning the cancer cells had reached and broken through the outer layer of the node. That means cancer cells could have escaped into the blood or lymphatic system and travelled afar . Currently, I’m as ‘okay’ as anyone can tell. With MRI scans denied me as a monitoring method (for someone with a very flat chest now), symptoms are unlikley to show until late on in any further instances . Anyway, all the best with the surgery, recovery and beyond
Dr told me having PET scan was not needed. Based on research Dr said chemo was next 4 rounds every 3 weeks then 3 weeks of radiation. I start chem next week Thursday and my med port Monday. I had 2 lumpectomies and 1 lymph node removed 12/10/25.
Surgeon scheduled a bone scan in June prior to starting my tamoxifen for five years.
I feel very much like you over this issue. I was quite firmly told that scanning for secondary breast cancer routinely was more or less pointless, as cancer cells can evade detection, and that it was only if you reported a sign or symptom of re-occurrence that hey would scan. However I feel that a ‘baseline’ scan would be useful straight after treatment has finished, not least to provide peace of mind (always a stranger to me) and am going to push for an MRI scan. My oncologist, although pleasant, seems to have very little time for discussion-I do not actually know what my prognosis is yet, 2 months into chemo-and i am reaching a point when I want to be a bit more assertive about what is happening to me-and that includes scanning!
I posted earlier in this thread about probably being de novo metastatic at the time I was diagnosed with a small breast tumour with no lymph node involvement. Liver met found a few months later when I had a scan for other reasons.
I queried at the time why I hadn’t had a baseline scan and like everyone else found it wasn’t part of the normal protocol when secondary spread wasn’t expected. My likely cause was vascular invasion at the tumour site (allowing cells to travel through blood), added to which I had grade 3 TNBC in the first place, which is an aggressive cancer. It gave my oncologist pause for thought over whether to scan when high risk cancers were involved.
If you are going to challenge your oncologist about it, the best place to start is to discuss risk factors. You are not having a discussion about the risk of recurrence, which treatment aims to minimise, but to tackle the question of whether it could already have spread before you started treatment.
Thanks Coddfish, this is useful, especially as I have a Her 2 pos cancer , and have missed a round of chemo due to allergy to taxanes. Will take the approach you suggest anyway.
. Currently, I’m as ‘okay’ as anyone can tell. With MRI scans denied me as a monitoring method (for someone with a very flat chest now), symptoms are unlikley to show until late on in any further instances 
. Anyway, all the best with the surgery, recovery and beyond 
