Question about nodes/staging

KellyA · 10-17-2007, 02:27 PM

I moved this quuestion from another thread hoping that someone may be able to answer.

Ok, I am going to "piggy-back" off of this question. I have a question also regarding nodes at the time of staging. When I had my axillary nodes removed, there were 3+ out of five. The entire clump of nodes was removed, yet there were only five present. I asked my onc if it was worse to have three out of five, say, then 3 out of 15 (based on percentage. He said no- that 3 was 3. I don't understand this, because it seems only logical that if I had had more nodes in the clump that more would have been positive. Does that make sense? Not that I am trying to up my stage or anything, I just wonder if I was more progressed?

Love, Kelly

janet/FL · 10-17-2007, 02:43 PM

Kelly,
I sure don't have the authoritative answer, but I think that the thought is that all of the clump of nodes would be positive before the next clump of nodes would be involved. If all had been positive, then they might want to take more.

Maybe some of the experts -- those that have had this experience--on this list would like to answer. I had 0 out of 7 negative. I wish they could have taken less, but my doc. said they couldn't as they were all clumped together. So it appears that it varies as to how many they study for a sentinel node biopsy. Hope my answer to you is right.!

Becky · 10-17-2007, 06:05 PM

When I had mine done, they took the first node but it also had a baby node there. Both, upon the quick inspection looked good. However, when pathology took a good look, I had 2 micromets to one of those 2 nodes (but not the baby node). Apparently if at least one node is positive, they need a total of 5 to be sure so I had to have surgery again for more nodes and clean margins on the DCIS side (if you remember, it was very small so the surgeon wanted a wide exicision so I could avoid radiation on that side (something that haunts me today)). So, she went in to get 3 more but they are clumped and she ended up getting 5 so I had a total of 7 removed and those 5 were negative. Your surgeon is right that 3 is 3 and the less nodes you have removed lessens your current and future chances of lymphedema or other skin problems on the affected side. Rest easy.

Mary Jo · 10-17-2007, 06:27 PM

I, like Becky, had 2 sentinel nodes that lit up or should I say turned blue during sentinel node mapping. During surgery and their inspection we were told "no cancer." But, also like Becky, after pathology went through them they found 1 micromet (.085) in the first node and the second node was clean. After much discussion with my onc. and surgeon I opted out of having any more nodes removed. They stood with me on this issue and believed that other nodes would be negative. My surgeon actually believed it could have come from the needle during sentinel node mapping. Of course none of us really know but I KNEW that I did not want any more nodes removed. So, although I had a right breast mastectomy and margins were clear - no vascular invasion etc. part of my treatment was radiation. Twenty eight days of it to the breast area - center of chest - node area underarm and shoulder in back. This was all done as added protection because I did opt out of anymore nodes being removed.

Mary Jo

KellyA · 10-18-2007, 03:15 AM

So, The sentinel nodes are or are not included in the # of nodes positive. ( I am guessing that when my results came back 3/5 +, that it did not include the sentinel nodes.

That s for the explanation, I have always been curious about that.

Love, Kelly

Becky · 10-18-2007, 03:41 AM

The sentinel node is included as far as how many nodes are positive.

KellyA · 10-18-2007, 09:45 AM

Thanks guys,
I have always wondered about that and it was one of the questions I missed with all of the original dx stuff. One of those things I wanted to know, but not enough to schedule to see my surgeon again- hee hee- He's wonderful and all, but I hope I never need to see him again. :-)

Love, Kelly