Silly question.....

Just wondering if anybody could shed a light on something. I got dxed on sept 28th. My ct, bone scan came back clear and my MRI showed nothing more sinister. Now my doc wants to do a sentinel node biopsy and this will determine if I have an immediate reconstruction or not…
Now thanks to the wonderful gals here I fully understand why and how this will be done, but does the MRI scan give the docs any I indication as to whether there is a spread to the lymphs??? Something new to worry about!!! My doc said it would be a journey of ups and downs. It sure is…
N xx

Neadi, one slapped wrist coming up - this is not a silly question; there are no silly questions, and you are right to ask this.

My circumstances were different from yours as the ultra-sound showed up one ‘suspicious’ node on day one, and I knew from then that full clearance was needed. It sounds to me that all your scans show clear nodes - that’s brilliant - but just in case a few sneaky cells have found their way into the ‘sentinel’ (guardians of good health) lymph nodes which would not show on any scan, they usually do a sentinel biopsy to be on the safe side.

Don’t want to patrionise you, cos i’m sure you are very intelligent, but basically they squirt blue, radioactive dye into the the breast, which will then find its way vai the lymph routes to the snetinel node or nodes (some people have one, others may have as many as three, we are all different). The surgeon will fish out those nodes and get them checked under a miscroscope. If there are any ‘micro mets’ they will be seen and they would plan treatment accordingly Btw micro mets in the armpit lymph nodes are not secondaries, so don’t panic at that term. If there are cancer cells in the sentinel nodes, it means they have done their job properly and stopped the pesky cells form getting into your lymphatic system. We hope there won’t be, but if there are it is ‘eminently treatable’ as my lovely surgeon put it.

Hope that helps a teeny bit. Keep asking questions as you need to.

PS I’m not quite sure of the relationship between snetinal biopsy and immediate reconstruction - I had axilary clearance and immediate reconstruction.

Hi Neadi, I asked my BCN the exact same question the other day as I am having a SNB next wednesday and have already had an ultrasound, Mammagram, MRI scan, two biopsy’s and one WLE - but all this was based on a diagnosis of DCIS which has now changed to IDC.

She said that sometimes the tests I have had would show suspicious areas re lymph nodes - and that some people present with obviously swollen lymph nodes (cue me spending all week jabbing at my armpit and convincing myself I can feel lumpy bits!) - but not always. What I think she was trying to say is that it is a positive that none of the tests / scans I have had so far raised any glaring red flags re lymph nodes - but the only real way of knowing is to have the biopsy. I think the level of involvement can vary massively - so there might be itty bitty cancer cells in our nodes that would only be picked up on a biopsy.

Re the recon - maybe it is to do with whether you would have to have radiotherapy depending on the lymph node situation? I am not having a mx but my BCN has said that if I had needed one then I would not have been able to have an immediate recon because my cancer is grade 3 and I will definately be having radiotherapy.

Hi there Revcat!
Thanks a million for the reply. Came out of the office yest with hubbie and we were looking at each other confused saying: " that’s good yeah??" when I asked doc if I should be happy he said " content is the word I would use…"
He said that if my lymphs were clear i wouldn’t have to have radiotherapy, therefore would qualify for the immediate reconstruction , if not I would have to wait…chemo either way…bah!
I go in next Thursday for the biopsy and results the following Friday. It’s the waiting that’s killing…
Thanks for reply!
N xx

Ah! I guess it depends what kind of reocnstruction then - a lot of surgeons won’t use permanent implants if you have to have radiotherapy as the nuking does them no favours; they might use a temporary expander instead. I had an LD flap which withstood rads absolutely fine.

Hope it’s all good when you get the results.

Thanks!! I daren’t hope, but am just praying for a positive result…

Brady just saw your reply - thanks for that! That sure makes sense!! Good luck with your tests xx

No worries - and good luck with yours too

I’m kind of lucky in that the surgeon will be using an OSNA machine to test my SLN while he is doing my WLE. If it comes back positive he’ll whip the other nodes out then and there. If it comes back negative he obviously won’t! Bit of a cliff-hanger for when I come round I suppose…

Ha!! Cliff hanger sure describes this!!!