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Forum Name: Breast Cancer

Question: Sentinel Biopsy not containing lymph nodes?


 ELLIE105 - Sun Dec 21, 2008 7:43 am

I am really worried.

I had a mammogram 3 months ago and is showed a spiculated carcinoma. I had a biopsy of the breast via xray as the lump could not be felt. This prooved to be cancerous and 3 weeks ago the surgeon removed a small lump that he said was very hard to find and the site was marked by xray first. He performed a setinel biopsy at the time and told me he took out 4 lymp nodes.

I was shocked the other day when he then told me that I am the first ever out of hundreds of his patients that all 4 samples contained no lymp nodes at all but were fatty tissue that the dye marked as hot spots. He said this is good news and he could not feel or see enlarged nodes. He said not to worry but my concerns are If the dye never reached the nodes in my arm pit then why not? also is there a chance that the lymp drainage would have diverted to another set of lymp nodes to my body elsewhere where a tumour may develope? He has not explained all this to me. I am now on tamoxifen and will under go radiation therapy as the treatment.
 Dr. Tamer Fouad - Mon Dec 22, 2008 12:01 pm

User avatar Hello,

Thanks for your post. I have to agree this is a very strange situation. Sentinel lymph node biopsies are very accurate when a lymph node is sampled. I do not really know what the prospects are when lymph nodes are not sampled but I think the outcome would be similar to not evaluating the axillary lymph nodes in the first place.

Many things are taken into consideration, but mainly your risk of metastasis. I think you should have a frank discussion with your doctors not about what the causes of failure for your test but about the implications it may have in the assessment of your outlook.

Please understand that I am not in a position to disagree with your doctor. In fact I do not, I am just saying he is the only one that can answer this question.

As for your second question: no I don't think the dye could have spread to another region. The breast drains to the axillary region of lymph nodes and we use the dye to help determine which lymph node within that region is the most likely to harbor metastasis.

The other option is axillary lymph node dissection which is associated with significant morbidity. Please keep me updated!

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