Sentinel lymph node with frozen section

Has anyone had this procedure?
I am due to have a lumpectomy and sentinel lymph node on Friday. They are trying to arrange it so that they take out the sentinel nodes, and pathology do a frozen section on them there and then, and decide if I need to have the rest of the lymph nodes out.
It sound really good as it means I wouldn’t then need a second operation if the nodes are bad. However, pathology are not keen to do it because of the radio isotope. My surgeon is busy emailing other hospitals where this has been done to try to persuade the pathologists to do it.
The alternative is that he could do the sentinel lymph node just using the blue dye, but I am not sure whether this would be as good.
I would be interested in hearing from anyone who has had either

Hi dibskelly,

I am under the Royal Marsden and had sentinel node biopsy performed when I had my mx in oct 09. I remember the surgeon coming into recovery and telling me that my node was clear and therefore they had only taken out the sentinel node and no others.
Mine was both dyed blue and had the radioactive isotope in and the histology form notes it as “hot and blue”.
I do hope that your surgeon sorts this out for you so that a potential second op can be avoided.
Hope this is of some help.

Regards,
Marjay xxx

Hello dibskelly,

Although I didn’t have the the immediate frozen section done I did have only the blue dye for my sentinel node biopsy - which is standard procedure at the hospital I was in. Hope your surgeon can sort it out for you and good luck with the surgery.

Eliza xx

hi,

i had snb in march and i had to have radioactive dye injected a few hours beforehand and special gamma xrays taken which guided the surgeon, then in the operation they injected blue dye as well. they did not test it then and there though i have heard that some places do this to avoid the need for second operation if cancer is found in the nodes. My results took 10 days. Good luck,
xxx

Hi there, I had SNB when I had my lumpectomy in Feb. I went to hospital the day before in the morning, had a radioactive injection then went off for 3 hours. When I returned they took some pictures (like a scan)and I took them with me next day for the op. They also used blue dye during the op. That way they found the sentinel node, sent it off at the beginning of the op, did the lumpectomy, and when I was in recovery the results came back. I was fortunate so I returned to my bed, but the idea was that if it came back positive they could just put me under again and do a clearance without the need to return at a later date. Fab! You do wee blue wee for a couple of days and my nipple is still a little blue 3 months on. Small price though!

I don’t know about freezing anything, but when I had my SNB, the hospital had some special equipment to test part of the sentinel node during the WLE op. If it was clear (which luckily mine was), then no further lymph nodes would be removed. If not, then they would have taken the others out whilst I was still anaesthetised. After surgery, the other part of the sentinel node was tested by the pathology lab to double check. I believe the equipment is expensive and I was fortunate that they had it where I had my surgery. I did have both the radio-isotope and blue dye injected on the morning of the op - blue wee, etc.

Ann x

Thanks for all the posts. Came home yesterday and I feel fine. They did the sentinel node with just the blue dye in the end (the pathologists were twitchy about using the radio isotope as it hadn’t been risk assessed). In the end they cleared all the nodes out, but at least they did it in one operation. It took about 4 hours though. Its a nice neat hole as my lump was near my arm pit, so he took everything out from one place. I had a very blue boob and blue wee, but both are fading. Have still got a drain in (I hadn’t realised it would be such a big bag of blood).
I think the idea of getting pathology to look at it there and then is definitely a good one they should do elsewhere, as I really couldn’t bear the thought of having a second operation.

dibskelly - I’m glad you have got through it and are feeling ok. As far as testing on the day goes, I suppose it depends on how the local health authority decide to spend their budget as I think the equipment is expensive.

Did they have reason to believe there was a problem with the lymph nodes beforehand? Otherwise, I wonder why they decided to remove them all, without testing just the sentinel node first.

Good luck with your results.

Ann x

Ann O4
Three of the nodes had shown up on the ultra-sound as swollen so they did an ultra-sound guided biopsy, but it wasn’t conclusive. The surgeon said that actually the sentinel nodes looked all right, but a couple of the others looked bad- will no doubt know more when I get my pathology results

Hi All
This is my first time in the forum and I’m frightened, I was diagnosed with BC on 7th May 2010. I had a small lump removed with SNB on 2nd June. They removed 3 nodes and one was found to be positive so now I have to go back to hospital next Wednesday 23rd June to have all my nodes removed. I’m so worried that the cancer has spread to other parts. Does anyone know what the likelihood of this is. The lump - by the way - was removed successfully.

Hi Kittie - I am sorry no-one replied sooner. You can always start a topic yourself and then it will definitely be noticed quickly.

As anyone will tell you on here, there are no ‘rules’ to breast cancer but the fact that only one of the three nodes was found to be cancerous has to be a good thing. When they remove and test the rest of the nodes, they will be able to give you a better answer. If it is only the one, then the likelihood of it having spread is greatly reduced.

Do let us know how you get on. You will get lots of support on here.

Ann xxx

Hi Ann
Thanks for your comment it is reassuring I did speak with the BCN and she also reassured me and my doctor also (but the reassurance never seems to last) I will be in touch after the op/results to let you know, but can I just ask; would you know if BC is different to other cancers, I mean if it spreads, does it behave differently to other cancers?

Hi Kittie not sure what you mean by does BC behave differently to other cancers?As Anne says all BCs are different And its good that that so far 1 /3 nodes are positive hope the op goes really well for you.( Mine is 24th but my nodes showed up on u/s and MRI so SNB ws not an option).For me the reassurance lasts until I get back to my car in the car park but then I am prone to major frets(lol) Hugs Jackie

Hi Kittie

Just wanted to say my sentinel node test was the same as yours 1/3 postive and to be honest the waiting for these results after the clearance was very hard.
I thought of every scenario, but in the end I just had to think- there is nothing I can do about it and it is not my fault that it is in the nodes so I will just have to get on with it. In the end there were no other nodes effected.
Nodes are just one part of your cancer. They are important but as the bcn told me knowing that there is cancer in your nodes informs the doctor about what treatment you need and it will be tailored accordingly to deal with that. You may receive a different chemo and rads to the lymph area possibly. dx