SNB . What can I expect?

Hi All, had pre oop today for SNB next week, dye on Wednesday Op on Thursday, what can I expect? any good suggestions please. Not nervous just another step to treatment plan and treatments I guess. Jane

Hi
I had my SNB and wide local excision on Wednesday. I’m happy to share what my procedure was.
I had another scan and insertion of a fine wire down into the breast to the location of the tumour; this was done under local and I didn’t feel any discomfort at all. It was done by an Advanced Practice Radiographer who was very proficient.
I then had a series of X-rays but I think that these were to enable the surgeon to do the lumpectomy and not part of the SNB.
Next was the injection of the radioactive substance this was a small injection just under the skin next to where the fine wire was inserted. Then a wait of 20-30 mins to allow the radioactive material to drain into the sentinel node.
Then 2 x 5 minute X-rays one on my back and one on my side to identify the sentinel node.
The next stage was to theatre, whilst under anaesthesia there is a blue dye injected into the fine wire that is picked up by the radioactive material and colours the sentinel node blue, so the surgeon can locate the sentinel node.
I had two wounds one on the breast where the wide local excision was done and one under my armpit where the SNB was taken.
I had no drain and my procedure was a day case. It is a long day with lots of waiting around but nothing particularly unpleasant or painful.
I’ve been comfortable since but you do need to take the pain killers. Be aware you will have some blue colouring on your breast and your wee is anything from blue to green! I drank lots and lots of water once home to clear out the dye!
I’ve also noticed that I have a very numb area under my arm. The Breast Nurse Consulant has assured me that this is common and is due to some nerve damage around the SNB she has has said I may have some residual desensitisation of the area.
I’ve been advised to leave the dressings inact for 5 days

Hope it goes well - as you say it is the next phase in the process

Yvonne x

Hi Janed
I had WLE and SNB at George Eliot, Nuneaton. It seems different hospitals have slightly different routines.

On the morning of my operation, I had to go to Coventry to the nuclear medicine department to have radio active dye injected just above the nipple on the affected side. (If the surgeon had not been able to feel my lump at pre-op, at this point I would also have had a fine wire inserted into the lump using an ultrasound machine), The injection was quite painful, but not unbearable by any means, and I’d say it was the worst part of the whole procedure, as nothing else was painful at all.

I had to wait for 3 hours for the dye to find it’s way to the sentinel node. I was advised to go into the ladies and massage the area for a minute every 20 minutes or so to help the dye to move. I went for a walk outside and accomplished this, under my fleecy jacket, without anyone noticing. but it did feel a bit weird groping myself in public!
After nearly 3 hours I was then called to be x-rayed. I had to take my bra off but was able to keep my t-shirt on so didn’t suffer any indignity at all. I had to lie on a bed holding my arms above my head, which was quite uncomfortable - I don’t know why they don’t have arm rests like they do in radio therapy! I was sort of fed into a large polo like machine on the moving bench for 6 minutes. The guy came back, let me rest my arms for a while and then repeated the procedure.

Then I collected the xray report from the reception desk and took it the other hospital where I was having my op. The surgeon drew on my breast with a felt pen where he was going to cut. This was a bit of a shock because the lines were longer than I expected and it seemed a bit of an invasion somehow.

After putting on a gown, DVT socks, a boob tube thing and my own dressing gown and slippers, I sat about waiting until I was called. I then walked with a nurse into the anaesthetic room and was given a general anaesthetic. The next I knew was waking up in the recovery room. Not too sore. The dressings were held in place by the boob tube, which was uncomfortable for me as I’m quite large so it was very tight.
I was given tea and biscuits, (probably too soon, as I was very sick) and allowed to go home (when the tablet to stop me being sick had taken effect!)

My BC nurse rang me the next day and told me to take the boob tube off and put on a well-fitting non-wired bra to hold the dressings in place. The wounds were glued rather than stitched so I din’t need the dressing other than for padding really. BCN also told me to have a shower the following day!

That was probably the single most scary part of it all. It seemed much too soon to me to be showering and I was scared stiff of looking at it. I eventaully made myself do it, and after that nothing was quite so bad. She was right. As she has been about everything! :slight_smile:

I too had a numb arm-pit and as some of the damaged nerves start to recover I got shooting pains down my upper underarm. A bit like nettle rash. This is common and normal. so don’t panic! It’s just the damaged nerve endings re-generating. My armpit is still a bit numb, 3 months on, so I use an electric shaver to make sure I don’t cut myself and apply deoderant using a mirror!
I found it a bit uncomfortable bu tnot really painful. I didn’t need painkillers. I had to visit the BCN at my local hospital to have the WLE wound drained a couple of times a week for about 3 weeks. This was a nuisance rather than painful, but I did get cramp type pains after she drained it. It felt like my body was going full tilt trying to re-fill the boob. but at least it was the same size as the other one while I had this seroma!!

All in all, like all these procedures, it’s not as bas as you think it’s going to be. I hope this helps.
Good Luck! x

Morning! I hope some of these responses are helping you. My expereince was …I woke up on the morning of my OP in my room ( they don’t have wards in Saudi, just individual rooms) and I was weeled down to Nuclear Medicine. The Radiologist injected this stuff into my nipple, it’s very quick! I then waited whilst they they used a Gamma something scan to watch the dye go into my sentinal node, which was a bit wierd… they then used a marker pen to put a huge X where it was. I went back to my room and waited to be called down to surgery.
I woke up back in my room in no pain whatsoever. was not allowed to eat/drink for 3 hours but I was bored enough to read my magazine! The recovery…the WLE I couldn’t even feel, I guess too much fat surrounding the nerves? The SNB scar was just itchy after a few days and just felt a bit more senstive, but absolutely NO pain at all.
Please be asssured that it really is ok…Good Luck!x

Hi Jane,
I had a stand alone SNB back in January 2011, the reason being if nodes were clear I could have recon at the same time as Mx which is what happened.
I had to visit nuclear medicine the day before my planned op. I had a needle which injected the radioactive liquid into the area by my nipple/tumour. Then had to hang around for a couple of hours before they could take the images which I can only say takes longer than an x-ray, from memory you have to lie still for up to 5-mins for each image and I had 3 from different positions. This was to spot the ‘brightest’ shining nodes where the radioactive liquid had moved to first - the sentinel nodes. I then went home and turned up for day case surgery next morning.
The blue dye was injected after I was anaesthetised & I knew that would happen. I think the dye is a double check against what the images from the previous day indicate - they go for the blue nodes & make sure they match the loaction highlighted by radioactive liquid. I was discharged later the same day after showing I could eat/drink/pass urine which was quite blue.
I had two nodes taken. My scar was slightly in front of my armpit and a few inches long running vertically. I had stitches so had to keep it covered and dry for a few days. I wasn’t in any pain, maybe a bit of discomfort as it crossed the line of my bra so I had to use a bit of padding to stop it rubbing that was all.
Hope that your op goes just as well, that you bounce back quickly and most importantly keeping everything crossed that the nodes are clear.
Sx

Hi Jane
I had my SNB carried out at the same time as the Wide Local Excision. My story is pretty similar although I think the location of the lump dictates where they inject the radioactive material… Or maybe it’s just Hospitals?
I had mine done at the Royal Derby… I had my pre-op assessment on the 16th April and went in for surgery on the 17th.
I was at the hospital for 8am, where I changed into a gown. I was then taken into a room where they squidged my breast into a couple of plates, one a grid, and then used ultrasound to locate the lump (which for me was on my left breast, on the left side of it). They nurse then gave me a local anaesthetic before inserting the fine wire into the lump (this is so they can find it in surgery). I have to say this was rather painful for me, even with the anaesthetic, but for others it didn’t seem too bad - I maybe have a low pain threshold! They then secured the wire around the entry point to prevent it wiggling too much and then covered it with a dressing to avoid knocking it. I was then wheeled about in a chair - felt a bit silly cus my legs were still working! But was told they like to keep you as still as possible once the needle is in place.
I was then taken to Nuclear Medicine where after a short wait I was injected with the radioactive material just on the edge of my nipple - this didn’t hurt at all, which I thought it would.
After this, I was then wheeled to the surgery area, waited for maybe 5 mins before they called for me and was then taken into the operation theatre pre-surgery room, where I got up onto the bed and was given a sedative… I don’t remember much past this - don’t recall the anaesthetic being administered or the countdown - I was gone before then!! They injected a blue dye into my nipple whilst I was in surgery which helps locate the nymph nodes to be removed.
I have been left with two scars - a two inch scar under my armpit where they removed the node (they only took one in the end) and 3 inches below that is another 3 inch scar where they removed the lump. I was stcuk back together with disolvable sutures and glue so went home with no dressings which meant I was able to shower straight away.
I have had to go back to the doctors since as a couple of ends of the soluble stitches had not dissolved quickly enough so were being pushed back out of my wound, which had almost healed, so there were a couple of bits (at either end of each scar) which weren’t quite healing. Now the sutures have been removed however, the scars have healed up totally.
For me, the hardest parts after surgery were not being able to drive, wear a bra (found this way too uncomfortable, even wireless), not being able to wear deodorant whilst the wounds were healing and not being able to shave that armpit! All silly details really but felt so much better in myself when I could go back to doing these things. Felt normal again… Almost!
Be prepared for some swelling and bruising - it isn’t a pretty sight at first but does get better in time and is really quite amazing how quickly our bodies heal themselves. I have also been massaging both wounds now fully healed with E45 cream to try and help reduce scar tissue internally as well as externally.
Also, depending on how many lymph nodes they are removing will depend on whether or not you will need physio after and whether you are at risk of developing Lymphoedoema (swelling / fluid build up in the affected arm). I was fortunate in that my movement wasn’t really affected - as soon as I could I tried to use it as much as possible and did the basic exercises I was given and have no issues at all now - and because I only had 1 lymph node removed, lymphoedoema hasn’t affected me - the risk of developing this is greater if you have several lymph nodes removed.
I don’t have any numbness around the scar area in my armpit but do have a numb area on my breast - to be expected as some nerves do get damaged. Whether this is permanent or not only time will tell and it is all so very individual they can’t tell you whether sensation will return.
Results from my surgery were clear - nothing in the nodes or around the lump and am waiting to begin my chemotherapy on the 5th June.

I hope your surgery goes well and that all these posts are helping you - fingers crossed they are clear and let us know how it goes
Big hugs
Emma xx

Dear All Thank you so much for all your replies, they are great, informative and straightforward, just what I need. Going in for the dye tomorrow, looks like I am going to be waiting in there awhile for it to work etc. Back in on Thursday for the Nodes to be whipped out. Hoping to enjoy a sunny jubilee weekend. I am a bit stressed with all the waiting for appointments etc. Seem to be having lots of checks before they deal with the lump.Will update this after Thursday.Thanks again Jane

for the op and hope it goes ok for you

Look forward to hearing how you’re doing :slight_smile: xx

Hope all goes well today and tomorrow Jane
Thinking of you
Yvonne x

Dear All, today went well, arrived at 10am and all over by 11am , the staff were lovely and the process was painless and worked first time. Thanks for all the tips, especially about the breast rubbing which luckily they provided a side room for, my lovely daughter kept me company and made me laugh despite her slight embarassment. in at 7.30 am tomorrow , and hope to post again soon. Jane

Anybody heard from Janed1808? I have not heard anything since a PM on 20th June - hope all is well.

Liz x

Hi everyone,
I just joined the forum today and this is my first post.
Im waiting to go for the operation for the removal of the small (can’t be felt) invasive cancer and the removal of one or two lymph nodes on the 1 October.
Your stories have been very helpful. I’m left handed and the cancer is in my left breast so I’m concerned about numbness etc.
Did you go on to get radiotherapy ? Hormone tablets? Do these make you tired? Put on weight? Any tips?

Hi Tayloe,

Welcome to the discussion forums where I’m sure your fellow forum users will be along shortly to give you some support.

For added support our helpline team are at hand for anything you need to ask, they’re just a free phone call away on 0808 800 6000, lines open 9-5 Mon-Fri and Sat 10-2.

Take care,

Jo, Facilitator

Hi Tayloe
I joined the forum about six weeks ago after my diagnosis and have been looking through the posts old and new, laughing and crying but finding it all very very helpful. Its so good to know there are people here who have been through/are going through the same as you and in lost of cases share the same feelings as you (which change frequently depending on where you are/who you are dealing with!)
I had a right sided (I am right handed) WLE and SNB on 26th August so not too long ago and feel quite well. I am in the North east, not sure if its the same everywhere, but I had this done as a day patient, in at 7.45 and home by 14.30.
My movement is good and without pain now. I would say - keep doing the excercises you are given, it is worth it although you are tender at the beginning. My lump was small and found on a mammogram. My PCT screens women from 47 and at 48 I had a mammogram and the lump was found so it was good timing for me.
I have good movement in my arm although I do have a weird feeling in the top of my right arm, its not really numbness just weird but not stopping any movement and as expected according to the BCN.
Twice I had to get some fluid drained after the operation and while the fluid was there the op site was aching but once it was removed which didn’t hurt everything was good.
Seen the surgeon last week who said the Lymph nodes were clear and he had good margins on the lump removed so awaiting an appointment with the oncologist to arrange the radiotherapy although I have started my hormone treatment but only last week so time will tell re weight gain, I am expecting it so if it doesn’t happen it will be a bonus!
I was tired at the beginning but I had also had a hysterectomy two weeks earlier (non related) so not sure if that was just my body recovering after both operations but feeling better now. Because of the hysterectomy I would have had the hot flushes without any hormone therapy but at this point in time they are not too bad so hope it stays that way (although I reserve the right to come back later and complain of their severity!)
Hope everything goes well for you and let us know how you get on.
Take Care
Karen

Hello everyone I too am a newbie, like Tayloe, although a bit further along in the process (I hope that is the correct wording!)

I came home from the gym on 6th July found a lump in the shower (mmm that sounds like it was lying on the floor or something) went to doctors on Monday 9th July, referred to consultant, saw him 16th July, had mastectomy and some lymph nodes removerd on 1st August, then back again on 21st August to have remainder of nodes removed as they removed 5 and 4 were affected. 5 remaining removed only 1 affected so on positive 50% clear. All a bit of a whirlwind, no time to get nervour during this.

Tomorrow I start chemo (TAC chemotherapy) 1 of 6 and then on to radiotherapy - feel nervous, but sooner it starts sooner it finishes - I am a positive person for most things - but do have moments of despair - I guess this is normal.

Just wanted to say hi to everyone - sure it will be ok and even though this is my first time posting I have read other posts before and feel like not going through this journey on my own, so thank you everyone and will let you know how I get on.

Thank you Jo, Karen and bistobear, it’s great to get such quick responses especially since they are directly relevant. have either of you been bale to wear your bras? All of mine are underwired and I’m getting a picture of women not using them or using cotton ones. Views?

Also I can’t thank you for replying, I am feeling a bit lost at the moment.

Eleanor

Hello
I’ve had my SNB done this morning (Karen, at the QE in Gateshead ) Feeling quite tender, some pins and needles in my hand. Arm is a tiny bit swollen, I’m thinking that may be just from having the arm straightened out for the op. If it’s still the same in the morn I shall get in touch with the hospital (BCC nurse is Mon- Fri)
Has anyone read about NOT lifting your arm above shoulder level for the first 10 days ? I did read that on here, somewhere, but I can’t find it and the search facility for the forum is not up and running yet.
Any advice for things you really should NOT do in the first 24 / 48 hours ?
and things you MUST do ?

Hiya Jood,
I used my arm as normal after my SNB, it was only after my full clearance i had issues lifting it high. Only thing i was told not to do is get the wound wet…well no bathing.
It healed pretty quickly from what i remember and no real pain. The stitches were dissolvable so disappeared on their own.
Hope the swelling goes down :slight_smile:
Rae
x

Thanks for replying Rae

Also stitches that dissolve and no bathing. I was expecting the wound to be in my armpit but it’s more on my breast…
The swelling has gone down now.
It just fels now like there’s a tennis ball in my armpit, even tho’ it’s not swollen under there at all (?) I was warned that things may feel ‘different’…I guess this is one of them…

J x

Hi Jood
I had my surgery there too.
Best advice is to do the excercises provided by the BCN (in your green book) regularly even if they seem to be easy enough to do.
I was able to lift my arm above my shoulder the next day but I had my SNB along with my WLE and they only took one or two so it may be different depending on how many they remove. I had to have the WLE sight drained a couple of times and asked the BCN if I had been doing more than I should of and she said the excercises I had been doing were fine.
Hope everything is better today and if there is anything I can help you with then please let me know
Karen