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Old 11-16-2015, 01:45 AM   #1
SpitFire
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Join Date: Dec 2014
Posts: 93
Sentinel Node Biopsy and Lymphedema Risk

I was told that because I had the Sentinel Node Biopsy (2 nodes), that I had No risk of lymphedema. I was told that I had No restrictions and that I could get my blood pressure and blood drawn on my affected arm.

Is this correct information?
__________________
8/2013 Diagnosed ER/PR Neg, Her2 Pos
FISH 6.86, Grade 2 (3,2,1), 10-15% Proliferation Rate 4.4cm
9/2013 Port Placement, Sentinal Node Biopsy 1/2 Nodes Positive having no extracapsular extension present
Stage IIb
9/2013 TCH
10/2013 TCHP
1/2014 End chemo!
2/2014 Lumpectomy Complete Response
2/2014 - 4/2014 Radiation
9/2014 Last Herceptin
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Old 11-16-2015, 02:27 AM   #2
Lucy
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Re: Sentinel Node Biopsy and Lymphedema Risk

I was told the same thing and have had my blood pressure and blood drawn on the affected side and had no problem. However, I will typically ask to have both done on the unaffected side now, just to be on the safe side.
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Old 11-16-2015, 08:55 AM   #3
Debbie L.
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Posts: 463
Re: Sentinel Node Biopsy and Lymphedema Risk

I think it would be more accurate to say that after SLNB your risk of lymphedema is lower. Even to say it's "very low". But probably not zero.

If you google "sentinel lymph node biopsy lymphedema", you'll see many discussions of this. Here's a copy/paste from part of an article at breastcancer.org:


"If you’ve had lymph node surgery and/or radiation therapy, you’re considered to be at some risk for lymphedema. How high your risk is depends on whether you have any other risk factors for the condition, outlined below. Some lymphedema risk factors are under your control and others aren’t — but knowing about them can help you gauge your risk level. You can talk about your situation with a physician, nurse, or therapist who specializes in breast cancer recovery and lymphedema management.

If there’s every reason to believe you are low risk, that’s good news! But it also doesn’t mean you are “zero risk.” You’ll still want to take precautions for avoiding lymphedema and get help quickly if you notice any signs or symptoms. If you have multiple risk factors, these actions become even more critical.
“In the treatment community, we’re talking more about the importance of developing a risk profile for every patient,” says Nicole Stout, MPT, CLT-LANA, Senior Rehabilitative Services Practice Leader at Kaiser Permanente, Mid Atlantic Region. “We must identify women at high risk and monitor them a little more closely for signs and symptoms and complications of lymphedema. But we also have to realize there will always be those ‘outliers’ who appear to be low risk but still develop lymphedema.”


Risk factors for lymphedema include:
  • Having more lymph nodes removed: Research shows that having more underarm lymph nodes removed increases lymphedema risk. Axillary lymph node dissection (ALND), the procedure that removes many or most of the nodes (typically anywhere from 5 to 30), is associated with higher risk than sentinel lymph node biopsy (SLNB).

    According to the National Cancer Institute, anywhere from 5-17% of women who have SLNB develop lymphedema. Among women who have ALND, the percentage is higher — from 20-53% — and risk increases with the number of nodes taken out. Whether you had SLNB or ALND, be sure to ask your surgeon how many lymph nodes you had removed, as this varies from person to person."
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Old 11-16-2015, 10:55 AM   #4
jaykay
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Re: Sentinel Node Biopsy and Lymphedema Risk

After my left lumpectomy and SNB in 2000, I used my right arm for blood pressure and blood draw all the time. Then I had a new primary on my right side, had a SNB and had my lymphs radiated. Higher risk for lymphedema because of the radiation so starting using my left arm for blood draw and blood pressure.

If you can use your other arm, you should

Janis
__________________
March, 2000: 48, Post menopausal (5 yrs HRT) Left breast, IDC 3mm/DCIS 1.6cm, ER+/PR-/Her2+++, mod differentiated, MIB low, lumpectomy, node neg via SNB, rads=33 Stage 1a
June, 2000: Tamox 4.5 years,Femara for 5 years (end in Jan. 2010)
Sept, 2012: 61, Via mamm, ultrasound, biopsy, right breast, 2.3cm tumor, ER+/PR-/Her2+++, poorly diff, KI67 60-70%
BRCA 1 and 2 negative
October, 2012: Bi Mast with tissue expanders, port placement
Final Path: IDC 2.8cm, DCIS, 1/4 sentinal nodes positive (@#$%). Stage IIB
Nov 29, 2012: Begin TCH/6x/every 3 wks, H for 1 year/every 3 weeks.
March 14, 2013: Finished chemo
April 9, 2013: Begin radiation 28x
May 22, 2013: Finished rads
June 1st, 2013: Started Aromasin for 5 yrs.
July 15, 2013: Switched to Letrozole (Femara). Probably for the rest of my life
October 16, 2013: Exchange surgery
October 31, 2013: Finished Herceptin
December 5, 2013: Port removed
Glad this year is over!
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Old 11-16-2015, 01:14 PM   #5
SpitFire
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Join Date: Dec 2014
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Re: Sentinel Node Biopsy and Lymphedema Risk

Thanks! I will use my other arm for blood draws and blood pressure from now on. My left arm has always felt like it is slightly asleep ever since I had my SNB surgery, but other than that, I don't have any swelling that I can see.

I also like to lift heavy weights. And I love my hot sauna in winter. I guess that I can keep doing those things? Is it possible that I could just wake up one day with a swelled up arm?
__________________
8/2013 Diagnosed ER/PR Neg, Her2 Pos
FISH 6.86, Grade 2 (3,2,1), 10-15% Proliferation Rate 4.4cm
9/2013 Port Placement, Sentinal Node Biopsy 1/2 Nodes Positive having no extracapsular extension present
Stage IIb
9/2013 TCH
10/2013 TCHP
1/2014 End chemo!
2/2014 Lumpectomy Complete Response
2/2014 - 4/2014 Radiation
9/2014 Last Herceptin
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Old 11-16-2015, 01:39 PM   #6
jaykay
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Posts: 645
Re: Sentinel Node Biopsy and Lymphedema Risk

Weights are not a problem but I think sauna is. I was told by my radiation oncologist not to do any kind of sauna. Check with your doctor
__________________
March, 2000: 48, Post menopausal (5 yrs HRT) Left breast, IDC 3mm/DCIS 1.6cm, ER+/PR-/Her2+++, mod differentiated, MIB low, lumpectomy, node neg via SNB, rads=33 Stage 1a
June, 2000: Tamox 4.5 years,Femara for 5 years (end in Jan. 2010)
Sept, 2012: 61, Via mamm, ultrasound, biopsy, right breast, 2.3cm tumor, ER+/PR-/Her2+++, poorly diff, KI67 60-70%
BRCA 1 and 2 negative
October, 2012: Bi Mast with tissue expanders, port placement
Final Path: IDC 2.8cm, DCIS, 1/4 sentinal nodes positive (@#$%). Stage IIB
Nov 29, 2012: Begin TCH/6x/every 3 wks, H for 1 year/every 3 weeks.
March 14, 2013: Finished chemo
April 9, 2013: Begin radiation 28x
May 22, 2013: Finished rads
June 1st, 2013: Started Aromasin for 5 yrs.
July 15, 2013: Switched to Letrozole (Femara). Probably for the rest of my life
October 16, 2013: Exchange surgery
October 31, 2013: Finished Herceptin
December 5, 2013: Port removed
Glad this year is over!
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Old 11-17-2015, 07:38 AM   #7
SpitFire
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Join Date: Dec 2014
Posts: 93
Re: Sentinel Node Biopsy and Lymphedema Risk

No sauna is a HUGE problem for me! If I haven't had any problems other than the slight falling asleep feeling since my SNB, then I should be fine, right?

If I were to get lymphedema, I would have it by now. My surgeon said that the beauty of SNB is that the risk of lymphedema is a thing of the past.
__________________
8/2013 Diagnosed ER/PR Neg, Her2 Pos
FISH 6.86, Grade 2 (3,2,1), 10-15% Proliferation Rate 4.4cm
9/2013 Port Placement, Sentinal Node Biopsy 1/2 Nodes Positive having no extracapsular extension present
Stage IIb
9/2013 TCH
10/2013 TCHP
1/2014 End chemo!
2/2014 Lumpectomy Complete Response
2/2014 - 4/2014 Radiation
9/2014 Last Herceptin
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Old 11-17-2015, 04:57 PM   #8
Becky
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Location: Stockton, NJ
Posts: 4,179
Re: Sentinel Node Biopsy and Lymphedema Risk

Lymphedema can happen anytime. Even 10-20 years from now.
__________________
Kind regards

Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 18 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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Old 11-17-2015, 05:20 PM   #9
jaykay
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Join Date: Oct 2012
Posts: 645
Re: Sentinel Node Biopsy and Lymphedema Risk

Were your lymph nodes within the radiation field? You should find out. You may also want to set up an appointment with a lymphedema specialist just for a consult. They are very helpful and will take initial measurements of your arms and advise on the risks.

Nothing against your surgeon, but better to be safe. Insurance will pay for the lymphedema consult
__________________
March, 2000: 48, Post menopausal (5 yrs HRT) Left breast, IDC 3mm/DCIS 1.6cm, ER+/PR-/Her2+++, mod differentiated, MIB low, lumpectomy, node neg via SNB, rads=33 Stage 1a
June, 2000: Tamox 4.5 years,Femara for 5 years (end in Jan. 2010)
Sept, 2012: 61, Via mamm, ultrasound, biopsy, right breast, 2.3cm tumor, ER+/PR-/Her2+++, poorly diff, KI67 60-70%
BRCA 1 and 2 negative
October, 2012: Bi Mast with tissue expanders, port placement
Final Path: IDC 2.8cm, DCIS, 1/4 sentinal nodes positive (@#$%). Stage IIB
Nov 29, 2012: Begin TCH/6x/every 3 wks, H for 1 year/every 3 weeks.
March 14, 2013: Finished chemo
April 9, 2013: Begin radiation 28x
May 22, 2013: Finished rads
June 1st, 2013: Started Aromasin for 5 yrs.
July 15, 2013: Switched to Letrozole (Femara). Probably for the rest of my life
October 16, 2013: Exchange surgery
October 31, 2013: Finished Herceptin
December 5, 2013: Port removed
Glad this year is over!
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Old 11-18-2015, 04:41 PM   #10
SpitFire
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Join Date: Dec 2014
Posts: 93
Re: Sentinel Node Biopsy and Lymphedema Risk

How do you know if your lymph nodes were in the radiation field? I had 1 out of 2 nodes positive Largest focus is 5mm having no extracapsular extension present. This was my radiation treatment:
Left breast + regional nodal radiation therapy: 4680 cGy/26 fractions
Lumpectomy boost: 1260 cGy/ 7 fractions

My breast surgeon's nurse took my blood pressure from my left arm. They told me there was NO chance of lymphedema. He is no longer my doctor.
__________________
8/2013 Diagnosed ER/PR Neg, Her2 Pos
FISH 6.86, Grade 2 (3,2,1), 10-15% Proliferation Rate 4.4cm
9/2013 Port Placement, Sentinal Node Biopsy 1/2 Nodes Positive having no extracapsular extension present
Stage IIb
9/2013 TCH
10/2013 TCHP
1/2014 End chemo!
2/2014 Lumpectomy Complete Response
2/2014 - 4/2014 Radiation
9/2014 Last Herceptin
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Old 11-18-2015, 06:55 PM   #11
jaykay
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Join Date: Oct 2012
Posts: 645
Re: Sentinel Node Biopsy and Lymphedema Risk

You need to ask your radiation oncologist that question.
__________________
March, 2000: 48, Post menopausal (5 yrs HRT) Left breast, IDC 3mm/DCIS 1.6cm, ER+/PR-/Her2+++, mod differentiated, MIB low, lumpectomy, node neg via SNB, rads=33 Stage 1a
June, 2000: Tamox 4.5 years,Femara for 5 years (end in Jan. 2010)
Sept, 2012: 61, Via mamm, ultrasound, biopsy, right breast, 2.3cm tumor, ER+/PR-/Her2+++, poorly diff, KI67 60-70%
BRCA 1 and 2 negative
October, 2012: Bi Mast with tissue expanders, port placement
Final Path: IDC 2.8cm, DCIS, 1/4 sentinal nodes positive (@#$%). Stage IIB
Nov 29, 2012: Begin TCH/6x/every 3 wks, H for 1 year/every 3 weeks.
March 14, 2013: Finished chemo
April 9, 2013: Begin radiation 28x
May 22, 2013: Finished rads
June 1st, 2013: Started Aromasin for 5 yrs.
July 15, 2013: Switched to Letrozole (Femara). Probably for the rest of my life
October 16, 2013: Exchange surgery
October 31, 2013: Finished Herceptin
December 5, 2013: Port removed
Glad this year is over!
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Old 11-18-2015, 07:03 PM   #12
SpitFire
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Join Date: Dec 2014
Posts: 93
Re: Sentinel Node Biopsy and Lymphedema Risk

Thanks jayKay
__________________
8/2013 Diagnosed ER/PR Neg, Her2 Pos
FISH 6.86, Grade 2 (3,2,1), 10-15% Proliferation Rate 4.4cm
9/2013 Port Placement, Sentinal Node Biopsy 1/2 Nodes Positive having no extracapsular extension present
Stage IIb
9/2013 TCH
10/2013 TCHP
1/2014 End chemo!
2/2014 Lumpectomy Complete Response
2/2014 - 4/2014 Radiation
9/2014 Last Herceptin
SpitFire is offline   Reply With Quote
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