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Treatment

 
Treatment

Chapter: 6 - Treatment

Subchapter: 6 - Lymph Node Removal

In addition to your surgical procedure, your doctor may wish to remove and examine lymph nodes; this is to determine whether the cancer has spread and to what extent. Your doctor will perform a Sentinel Lymph Node Biopsy and/or an Axillary Node Dissection. Let’s discuss both methods.

Sentinel Lymph Nodes and Sentinel Node Biopsy
While it is not easily controlled, the spread of cancer is sometimes predictable. The cancer cells spread through a customary path, out from the tumor and into the surrounding lymph nodes, before they progress throughout the body.

To be able to identify the sentinel lymph node, the surgeon will inject dye or a radioactive tracer into the tissue near the tumor; the lymph nodes that are the most susceptible to the cancer’s spread will be marked by the dye or a radioactive tracer. During surgery, the lymph nodes will be removed and checked for the presence of cancer cells.

Axillary Node Dissection
To determine if the cancer has spread to the lymph nodes, examinations can be performed with ultrasound and more carefully by removing one or more of the first draining lymph nodes with sentinel lymph node biopsy. Patients with a tumor that has spread to these lymph nodes may require complete removal of the lymph nodes in the armpit, a procedure known as an axillary lymph node dissection. An axillary dissection is generally performed subsequent to a sentinel lymph node biopsy, unless a woman has had a positive fine needle aspirate of a lymph node.

A mastectomy or lumpectomy operation often includes a sentinel node biopsy and/or an axillary node dissection; both procedures involve a separate incision for lumpectomy patients. Following surgery, the pathologist will test the lymph nodes to determine whether the cancer has spread to the lymph nodes.

Lymphedema
Removing lymph nodes raises your risk for developing Lymphedema, a condition that may cause abnormal swelling of the arm, breast, axilla, or chest wall on the side of your cancer. Swelling up to one month after surgery is not unusual and does not indicate the presence of lymphedema. However, if you experience new or persistent swelling in these areas after one month has elapsed since your surgery, you should notify your doctor.

Related Questions

  • Becky N Profile

    When does swelling in axillary area go down after lumpectomy. It feels like a fat lip! Lumpectomy was 8 days ago. Arm is fine, incision looks great! Thanks gals xoxo

    Asked by anonymous

    Stage 2A Patient
    about 5 years 6 answers
    • View all 6 answers
    • Thumb avatar default
      anonymous
      Stage 3C Patient

      It could be a bit of fluid build up that the surgeon needs to drain. I'd call the surgeons nurse Monday morning and ask if its still really puffy. You should have a follow up appointment soon too.

      Comment
    • Thumb avatar default
      anonymous
      Learning About Breast Cancer

      For me it took about 2 months for my swelling to subside. My dr stuck a needle in the area but to drain it no fluid came out. That was painful no numbing when done. 9 months since surgery 6 nodes removed. No swelling small incision & no further problems. So there is relief coming soon. I...

      more

      For me it took about 2 months for my swelling to subside. My dr stuck a needle in the area but to drain it no fluid came out. That was painful no numbing when done. 9 months since surgery 6 nodes removed. No swelling small incision & no further problems. So there is relief coming soon. I must agree it felt really freaky trying to put my arm down with the swelling

      Comment
  • Adrianne Geppert Profile

    What is the histopathologic grade or nottingham grade of my tumor from the pathology report from the biopsy.

    Asked by anonymous

    Learning About Breast Cancer
    about 4 years 3 answers
    • Sharon Danielson Profile
      anonymous
      Survivor since 2007

      google those words or there is a site that will interpret your pathology report. You can put in a Google search how to interpret my breast cancer pathology report. . In the long run, it would be best to have your doctor tell you what it is..... Then it will be about your case not somebody...

      more

      google those words or there is a site that will interpret your pathology report. You can put in a Google search how to interpret my breast cancer pathology report. . In the long run, it would be best to have your doctor tell you what it is..... Then it will be about your case not somebody else's.

      Comment
    • Lou Cam Profile
      anonymous
      Survivor since 2013

      There is a scale from 1-3, that is based on how abnormal the cancer cells are. 1 is not as abnormal, fast growing, and aggressive as grade 3 would be. And 2 is intermediate. Sometimes the scale will be 1-9. The higher the grade the more abnormal the cells are.

      Comment
  • Connie Demarest Profile

    Is chemotherapy (except aromotase inhibitors) used for stage 1 lymph node negative breast cancer?

    Asked by anonymous

    Learning About Breast Cancer
    almost 7 years 3 answers
    • Betsy Chapin Profile
      anonymous
      Survivor since 2010

      Hi Connie,
      You have a lot happening this week. You will get through this. Sometimes the toughest part of treatment Is waiting. I believe you will have answers when you see your oncologist this week. Stay strong.

      Comment
    • Betsy Chapin Profile
      anonymous
      Survivor since 2010

      Yes one could have chemotherapy with a stage one diagnosis. I was stage one and had chemotherapy with no lymph node involvement due to the fact that my cancer was HER2 positive.

      Comment
  • Misti%20 Hillis Profile

    Which is best, core biopsy or excisional biopsy?

    Asked by anonymous

    Learning About Breast Cancer
    over 6 years 2 answers
    • Anne Marie jacintho Profile
      anonymous
      Survivor since 2003

      Morning Misty
      The type of biopsy is one of those choices which is best for you. A core biopsy is less invasive. With the assistance of xray they go in with a big bore type of needle or cone knife and remove part of the suspicious area.

      With an excisional biopsy after dye localization. Using the...

      more

      Morning Misty
      The type of biopsy is one of those choices which is best for you. A core biopsy is less invasive. With the assistance of xray they go in with a big bore type of needle or cone knife and remove part of the suspicious area.

      With an excisional biopsy after dye localization. Using the assistance of mammogram the radiologist inserts a wire to inject dye to the suspicious area. The surgeon then goes via incision and removes the dyed are taking the specimen back to the radiologist to make sure by xray assistance again that the entire suspicious area us removed.

      I had my biopsies in 2003, 2005, and 2008 each by incisionsl biopsy to me it was peace of mind I knew the day of the procedure the results as my surgeon had a pathologist reading it while I was recovering from the anesthesia and he knew that he had clean margins. He removed the entire suspicious are. You can read my personal experience at http://home.roadrunner.com/~amj. I take you from my initial abnormal mammogram, the biopsy, surgery and recovery period. With a reflection a year later.

      Hope this helps. The more information you have the easier it is to decide what us best for you. Ask questions to the doctors and the nurses, what would they do how did patients handle the procedure. As my doctor said educate yourself. Be your own advocate for your care

      Take care

      Comment
    • Misti%20 Hillis Profile
      anonymous
      Learning About Breast Cancer

      I had a lumpectomy which is assume is about the same as an incisional biopsy sixteen years ago. The mass was benign but this mass is aggressively growing and I also am experiencing burning in my nipple? I am wanting the quickest result.

      4 comments

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