Lymph Nodes

Hi All

I am a little worried about how it is discovered whether lymph nodes are involved in the breast cancer. Is this picked up on the scans ?

No one has mentioned them to me so I’m assuming they are clear. Also if they are involved are the lumps obvious? My onc always examines me before each chemo, under arms etc. so I’m assuming mine are clear?

Cecelia. x

Hi Cecilia,

Have you had your op? I had 11 nodes removed with my WLE, 1 was affected. No evidence of lumps or anything. Sorry, I don’t know your history.


Hi Margaret

No I haven’t had my op, I’m having chemo pre operation.

Cecelia. x

Hi Cecilia

My surgeon picked up one lymph node at the initial examination, subsequently the mammogram, ct scan and ultrasound also caught it - i couldn’t feel it though! Like you I’m doing chemo first.



I had mine ultrasounded before and during chemo (like you I am chemo first). Apparently they look clear but they will take 12 away when I have my WLE at the beginning of Oct. This means they can be sure.

I asked about the sentinel node biopsy (where they put in blue dye) but was told that the results are not so certain if chemo takes place first. So out the little lymps have to come

Good luck
Sharon x

Hi Cecelia,
I had WLE and sentinel node biopsy in July - they took 2 nodes and both showed micrometastatic spread. I am now on chemo and need a full axillary dissection when I’ve finished my 6 cycles of FEC - then rads after surgery. My understanding is that it is extremely difficult to determine spread to the lymph nodes through scans and ultrasound - it appears that the safest dx is made following surgery, when they can have a good look at the nodes under the microscope. I think you should pose the question to your onc when you next see them - and ask them to explain what they are looking for when examining you.
All the best

Hi Cecelia -
When I had my recall from a travelling mammo unit, gor the normal 3 yrly mammo for over 50’s I had the 3 step programme at the hospital - compression mammo, ultrasound and core biopsy, all within 2 hours. The Director of the Breast Care Clinic actually did the ultrasound and biopsy - don’t know why. They she took my husband and I into a consulting room and gave us tea in china cups! This was on the NHS so I knew I was in trouble. They explained I had a tumour (never mentioned the word cancer) and I needed either a Wide Local Excision and radiotherapy, or a mastectomy (which frightened me witless as I didn’t even have a palpable lump, and my GP checked this out on both breasts) without rads. They also said I would have some sample nodes removed. I at that time had no clue what lymph nodes were, and the breast care nurse at that meeting showed me a diagram. In the WLE they took out 8 nodes, 3 were cancerous, so I went back a month later for total axillary removal - much more painful than the WLE. In total I had 18 nodes removed, and 1 more was cancerous, so this was when chemo reared its’ ugly head, which of course, I had, along with rads.

I believe women (don’t know about men) have varying number of lymph nodes under the armpit, some have as many as 50, some as low as mine, 18.

As far as I know cancerous non palpable lymph nodes cannot be picked up on a mammo or ultrasound. They have to take them out and send to pathology for diagnosis. I am not sure if palpable lumps in the armpit mean cancer. I think it is just best practice to sample lymph nodes when removing a tumour or DCIS/LCIS in case the cancer has spread. I was unlucky, but many women with bc don’t have the spread.

After my two surgeries, and whilst beginning chemo, I had various scans on my liver, bones and lungs. All were okay. This again, is just a precaution to see if the cancer has spread to these organs. I don’t know the statistics on this spread, but think it may be low.

I didn’t understand at the beginning of my treatment why I needed chemo and radiotherapy. It was explained to me that the chemo is to “mop up” any stray cancer cells that may have gotten through the lymph nodes, and the rads is further insurance to zap any stray cancer cells that may remain in the affected breast.

I am not quite sure where you are in treatment - you mention seeing an Onc, so are obviously having, or about to, have chemo. Is this neo-adjuvant treatment to shrink the tumour before surgery? If so, this could explain why the Onc feels your lymph node for any sign of swelling.
When you have surgery, they will either do the new sentinel node biopsy, or the full sampling like I had, as sentinel node biopsy was not available at my hospital in Devon when I was diagnosed 4 and a half years ago. I think I am right in saying that no doctor - surgeon or oncologist can tell if a lump, malignant or otherwise, is cancerous just by feeling, mammo or ultrasound. (A cyst however can be aspirated and if fluid comes out, is usually benign.) It needs a biopsy of the tissue and a pathologist’s report. Same with lymph nodes.

I am sure if I have got any of this wrong, none of us are doctors, someone will correct me, as I would hate to give you wrong information.

Hope all goes well with your treatment.


Cecilia -
P.S. sorry I didn’t read your later post properly. I understand now that you are having chemo prior to surgery. I apologise for my error, but the rest of my post makes sense, I hope!


I was scheduled for mastectomy and SNB as my surgeon was pretty confident I had no node involvment just a large lump, this then changed to full node clearance upon SNB results during surgery.

Path results 15/20 affected, yet nothing was felt under my arm on several examinations.


Hi Cecilia

when I first went for the needle biopsy I had an enlarged node they put a needle in this at the time and drew off cells which were negative, they knew it was enlarged because of the scan had shown it up thankfully all my nodes when removed were clear…


Dear All

Thanks so much for all the information. I will talk to my onc with regard to how they are looking for infected nodes. What does WLE stand for by the way?

Cecelia. x

WLE = wide local excision

Cutting the lump out!

Margaret x

Ah! Thanks, was wondering that for ages, but was afraid to ask!

What is the operation like? Is it very painful?

Cecelia. x

Please always ask! That’s the only way to find out.

I was worried about the anaesthetic as I’d never had an op but no problem. Op was fine too. I would say more discomfort than pain. It did not bother me at all as I was just pleased that it was over. As soon as I came round I ate a 3 course dinner as I was starving. Went home 2 days later and was fine - straight into pretty normal life and enjoying food and wine in the garden. The only problem was having to carry the drains (bags collecting post-op fluid) everywhere with me for a couple more days!

How are you doing with chemo?

Margaret x

Hi Margaret

Thanks for the reassurance. I have had a general twice now, for appendix and fibroadenoma a few years ago so I should cope with it I hope.

I’m doing OK with the chemo. This week being days 10-14 after chemo I always feel my lowest, bit more nauseous than usual as it’s now 11 days after chemo number 4. I’ve never been sick though and have not had any other major traumas with it.

And I’m still working and living life and feeling generally OK. Keep needing to get up in the night for a toilet break and having hot flushes, but generally not bad.

Thanks for the info and reassurance, this site has really helped me out.

Cecelia. x

I had WLE sentilel node and node sampling, 2 nodes out of 10 affected. The WLE was fine, came home the same say. NO problems for first weeks then needed draining. This was real easy and relieved the discomfort. Most important is to do the excersises after the op. Little and often is my advice. that way you gain movement without too much build up of fluid. Good luck with the op

Thanks Jewjew

Cecelia. x

Hi Cecelia,

I had a total axillary clearance along with my mastectomy in March. Personally I felt no strange under arm lumps at all, yet when they removed 28 lymph nodes 25 of them were affected! Strange!!

I’m sure your onc will be able to explain whats what, but personally I never knew I had nodes affected until after my surgey,

Take care and all the best with the rest of your treatment,