Lymphedema & 2nd sentinel node biopsy

DancerDonna · 07-27-2010, 07:15 PM

I have breast cancer again in the same breast as the one that had it five years ago. Also, I'm HER2 + (both old and new cancers). Had a lumpectomy and sentinel node biopsy the first time. Got lymphedema in both arm and hand a year later, although I only lost three lymph nodes. Got a terrific breast infection that caused it.

The new plan is to have a mastectomy with either SIEA or DIEP reconstruction by Dr. Ver Halen in Memphis. Saw the breast surgeon today who works with him. She plans to try to redo sentinel node biopsy again. Says she's done it again on some other women, but none of them already had lymphedema. So she doesn't know if it will cause it to become worse.

My breast surgeon in Nashville who did the lumpectomy and sentinel node biopsy five years ago said the same thing. She's repeated sentinel node biopsy, but not on any women who already had lymphedema.

If the Memphis breast surgeon can't identify a sentinel node, she plans to remove all of the other lymph nodes that are in the first level or layer. She said that some individuals have only five in this layer and others have fifteen. So I don't know how many I may lose with this surgery. That scares me some.

So has anyone had repeat sentinel biopsy who already had lymphedema? If so, what were the effects on the lymphedema?

Or has anyone had attempted repeat sentinel node biopsy and instead, had a breast surgeon remove the lymph nodes in the first layer?

I'd appreciate hearing about your experiences. Thanks.

Jackie07 · 07-28-2010, 03:36 AM

DancerDonna,

From what I've read so far, it is possible to have surgery (biopsy and/or reconstruction) while having lymphedema.

Here's one paragraph I found concerning reconstruction:

"Most patients who undergo reconstructive surgery after breast cancer do well. Of course, patients with existing lymphedema are, and should be, concerned about worsening their lymphedema. The same guidelines as for breast cancer surgery should be followed during recon-structive surgery. Ideally, some intensive manual lymph drainage prior to surgery is in order to be in optimum condition."

Many of us have had more than 10 lymph nodes out. I think everything should go quite smoothly because you've had only 3 lymph nodes taken. Even though you have lymphedema aleady - your doctors should be able to figure out ways to avoid complications.

The best way is probably to find other surgeons' opinion/experience on the procedure. Perhaps some of our members who are having (or just had) surgery can ask their surgeon about it.