• Sentinel node biopsy

    Asked by Judy11 on Thursday, July 24, 2014

    Sentinel node biopsy

    I'm scheduled for surgery next month. My sentinel node biopsy is scheduled for two hours before my mastectomy. Can somebody please explain to me what to expect and why it's not being done all at the same time? I'll see my breast surgeon before my surgery, but that's a ways off so I'd like answers sooner. Thank you

    24 Answers from the Community

    24 answers
    • barbdee's Avatar
      barbdee

      My radiology Dr. used an ultra sound machine in order to "see" where to place thin wires, it is a guide for the surgeon when performing the operation, no matter if lumpectomy or mastectomy. They numb you up pretty well, but it does get your attention, The other part you didn't mention is the procedure when they insert the blue dye into the affected breast. The dye was put in the day before the wire procedure, After the ultra sound, the Dr. inserted the sentinel node wires, they put a Dixie cup over my breast & we went to the hospital for my lumpectomy. In the San Diego area some hospitals/groups give you the results while still in surgery, others do not. Sounds like you get the one day visit. Wishing you all the best. Barb

      over 6 years ago
    • Ejourneys' Avatar
      Ejourneys

      My SLNB was done at the same time as my lumpectomy, but a couple of hours prior to that I had a lymphosinctigraphy -- that's where they inject radioactive tracer into the breast to find the sentinel lymph nodes. No wires were used with me. The blue dye was used during my surgery.

      During the lymphosinctigraphy I received four injections (one for each lymph node removed). The first injection was fairly painful but quick; the second was less painful; the third and fourth were a piece of cake. I then had to massage my breast for 20 minutes, then had to hold still while pictures were taken. The entire procedure took about an hour in the nuclear medicine department. Once that was done I had to wait for my turn in the OR.

      over 6 years ago
    • PaulineJ's Avatar
      PaulineJ

      I had b/c surgery the end of July 2012.And lymp noyeds (6 out of 8 ).But a few hours beforeI had an ultra sound with needles one after the other up to at leasst 5 times the end of Aug.Sorry but those needles were one of the worst pains I felt.I know it's different for everyone from reading different posts and comments,but for me I would not want to experience that again.They did not numb me whatsoever where I went.And from reading here that everyone else was numbed up before.Just make sure you find out and insist on being well numbed up before they they put those needles in you.

      over 6 years ago
    • PaulineJ's Avatar
      PaulineJ

      I find that you get more information and answer on this group then any doctors.As for me I don't get straight answers form them .And have to persue things to get anything done..As much as I like my cancer surgeon I don't feel I got answers that I may not understand yesterday on the arimidex and stuff.I remember hearing him say it helps to live a little longer.scary!At almost 70 I sure would love to not take them for another 3 years ,because of all the side effects I get with all the other aches and pains,etc I get for everything else I have wrong with me since 1998.I guess what I'm saying is that everyone here have so much information for you.

      over 6 years ago
    • MLT's Avatar
      MLT

      I'm guessing the sentinel node biopsy is 2 hrs before surgery so pathology can get test results back to the surgeon before Mx, If they are positive, you may have an axillary dissection (removal of lymph nodes) during the surgery. I had the radioactive tracers injected 2 hrs before surgery and the blue dye. Sentinel node biopsy same time as lumpectomy. Call and get clarification from the Dr office. Have them talk you thru the procedures. Wishing you the best.

      over 6 years ago
    • ld_105's Avatar
      ld_105

      I received directions before surgery explaining what would occur the day of surgery. I had an ultra sound, then a mammogram assisted wire placement, after that one large shot in the center of my breast to inject the dye. I had to transfer to the hospital from the cancer center and th wires were taped down to prevent then from moving.....there is a length of wire projecting out of your breast but you will get lidocaine to numb your breast as they do this. Once I was out the BS performed the mastectomy and removed four lymph nodes. They are checked during surgery so that my surgeon reported that they were clear when I saw her once I woke up. There wasn't a two hour window between procedures but you need to get there early to complete all of the steps, wire placement, nuclear shot, etc. I would clarify with your surgeons office. Sometimes you will get more information from the office manager or assistant...my doctor has a very efficient Secretary who organized all of these procedures plus the availability of the plastic surgeon. Good luck.

      over 6 years ago
    • Misty's Avatar
      Misty

      Let your surgeon know that you are really uptight about the sentinel node biopsy. When mine realized how stressed I was getting over it he decided to do it at the same time as my mastectomy. Most doctors are compassionate and will go the extra mile to ensure that your "ordeal" goes as smoothly as possible for you.

      You have enough to worry about when facing surgery. You shouldn't be stressing over it the way you are as it isn't good for you. It is not that big a deal to do the biopsy as soon as you're under anesthesia. The rest of the surgery takes long enough that your surgeon should have sufficient time to get a path report back before finishing your mast. and any sentinel nodes that need to be removed.

      Good luck! I hope your surgeon is as understanding as mine and that your surgery and follow-up treatments go well for you.

      over 6 years ago
    • PinkPeony's Avatar
      PinkPeony

      I had a wire, but not to locate the lymph nodes. There was a marker placed in my breast at biopsy, and the wire was placed to guide the surgeon to the tumor location. If you have a tumor that cannot be felt or seen, the wire is so the surgeon can locate the surgical site.The insertion did not hurt at all, but do make sure they are using something to numb you. The radioactive tracer was done before surgery, and this hurt but only briefly. I think the dye was injected during surgery, but am not sure. My face was a bit ashen from the blue dye, and it also caused colorful bathroom experiences for about three days after the surgery. I took a lorazepam before leaving the house for the hospital. Ask your doctor for something, and he/she will give it to you if that is something you want. It was a long day, but really not bad. If anesthesia makes you sick, be sure to tell the surgeon and your anesthesiologist that you want something to keep you from becoming sick. They gave me a patch and something in the drip line which worked wonders. It is the first time I have not been sick from anesthesia, and made for a much better experience! Sending hugs and good wishes to you for an easy surgery.

      over 6 years ago
    • rrabunal's Avatar
      rrabunal

      Dear, it is probably to inyect the radioactive tracer to the sentinel node. They do it a few hours before the surgery to be able to find this node easily during the surgery. This is what was done to me. It does not hurt, it is just uncomfortable for a few minutes. The biopsy of the node(s) is done at the same time as the surgery as far as I know. I would call the Dr. for your own peace of mind. It is hard to process all the info they give as at once, so don't hesitate to find answers from your Dr. Blessings, Roxana

      over 6 years ago
    • Roadrunner's Avatar
      Roadrunner

      I felt worn out before I got to surgery for my double mastectomy. First I had the ON-Q lines put in and THAT was the painful part and I would NEVER do them again. Then I was taken to the radiology department and given a shot of radioactive tracer to find the sn. In my case they went in and got the sn first, got a path report on it and then on with the surgery. It tells the surgeon if the cancer has spread beyond the tumor and this is an indicator of how many lymph nodes they will remove. It seems every doctor does this differently so if you have questions don't be afraid to call the doctors office and talk to the nurse or the doctor. The hospital where I had surgery had a GREAT class about a week before surgery that went over everything that was going to happen.....it took the fear out of the day.

      over 6 years ago
    • Ratbike's Avatar
      Ratbike

      Just had this done in June. As stated above, the procedure consists of injecting radioactive dye/tracer into the breast (the injections were painful for me), and imaging of the sentinel nodes (main ones leading from the breast) so the surgeon can dissect those for pathology during your mastectomy. They are evaluated immediately so the surgeon will know whether more lymph nodes need to be removed (or not) during your procedure.
      Looking on the lighter side, it did provide distraction of a sort from the "main event", the people in nuclear medicine were very friendly, plus I got a wheelchair ride to and from!

      over 6 years ago
    • tam4givin's Avatar
      tam4givin

      They took me from pre-op to radiology in a wheel chair to inject the radioactive tracer , it was very painful. There is a cream that some people get that is suppose to numb the nipple area. Everyone thought someone else had given it to me so it got put on right before I went there, about a half hour before shots. Shots were very painful! Some people say it was not that painful to them. The radiologists assistant told me it was good it hurt that means the radiologist got the dye exactly where it needed to be. No wires. Biopsy of sentinel nodes was done in the operating room after I was asleep when they did the mastectomy.

      over 6 years ago
    • luv's Avatar
      luv

      request them to only remove 5 or less nodes, Only give permission to remove more if intact the first 5 tested positive for cancer, otherwise there no reason to take more, and then you get complications with lymphadema, do yoga and don't stop. may prevent getting lymphadema.

      over 6 years ago
    • Judy11's Avatar
      Judy11

      Thank you all for your responses. I have an appointment with my BS before my surgery so I'll be sure to ask lots of questions.

      over 6 years ago
    • tam4givin's Avatar
      tam4givin

      Ask if you will be given a compression bra or camisole at the hospital. They just pinned my drain bulb to my gown and the camisoles I had bought before surgery were uncomfortable so I continued to pin to clothes. I ended up having it 2 months, so after about a month the tubing rubbed on my skin and made a bad spot that they thought was fungus then bacterial infection until a skin nurse put a special bandage on to clear it up.

      over 6 years ago
    • luv's Avatar
      luv

      Good idea about the camisole. Find one that has spandex in it, it helped to hold everything together it was so nice and stretchy! Or they make cam is just for holding a pump i think it buttons in the front. Do you have button front shirts, easiest way to get dressed!

      over 6 years ago
    • PinkPeony's Avatar
      PinkPeony

      I was told that if I had drains the hospital would give me a special camisole to wear home. (One with pouches.) Something else to ask your BS! :) Also, if you have a mastectomy, the pouch cami has padded cups.

      over 6 years ago
    • LindaAnnie's Avatar
      LindaAnnie

      I wish I had known to ask for something to numb my breast!!! A couple hours before surgery they wheeled me down to radiology to insert 4 guide wires to the tumor -- in and around the nipple. This was done under a combination of mammogram and ultra sound. I have to say it was the worst pain I have ever felt. Thank heaven for sweet nurses who held my hand and dried my tears. Then the nuclear doctor came in and shot in the radioctive blue dye (2 or 3 shots I think). After wheeling me back to pre-op, the anesthsiologist gave me something to relax and for the pain while waiting for the dye to move thru. During surgery the doctor removed only the nodes that "lit up" for the biopsy.

      over 6 years ago
    • tam4givin's Avatar
      tam4givin

      The numbing cream did not help at all. I guess any real numbing stuff might interfere with the dye. I did not have guide wires. Are they used just for lumpectomy not mastectomy sense the whole thing is being cut off?

      over 6 years ago
    • MLT's Avatar
      MLT

      I had a wire for my first lumpectomy. The tumor was hard to find. I was numbed and that procedure was not painful. Next surgery was sentinel lymph nodes and further lumpectomy after I switched to a more competent surgeon. Injecting the raioactive tracers (4) around the nipple was not painful for me.
      I didn't have the On-Q for mastectomy, but did for knee replacement (wasn't painful) and later for DIEP reconstruction. The last one was put in during surgery. This system is great for pain control! Never heard of it being used for Mx.

      over 6 years ago
    • MelanieIIB's Avatar
      MelanieIIB

      I would definitely call your surgeon's office and ask the nurse your questions. I agree with those who say you will probably have the sentinel node taken and biopsied before surgery so the surgeon knows whether or not he/she has to take more than just the sentinel node. Not all surgeon's do it hours before surgery though so only your surgeon's office can give you the answer. For my first mastectomy, I received the blue dye (lymphocintigraphy) the day before surgery and my surgeon took the sentinel node at the beginning of my mastectomy so it could be tested, since it was found to have cancer, he removed all of my lymph nodes 18 (axillary dissection).

      As far as the "wire localization" that others are talking about, it is put in by a radiologist and is used to pin point the exact location of the tumor for the surgeon before you have a lumpectomy or a surgical biopsy, not for a mastectomy. With a mastectomy, all the tissue is taken so there is no need to pin point the exact location but with a lumpectomy or biopsy, only the tumor and surrounding area is taken so it is important for the surgeon to know the exact location. I had a wire localization on my remaining breast so that the tumor could be biopsied.

      over 6 years ago
    • Swimmer's Avatar
      Swimmer

      I am 73 and had sentinel node biopsy yesterday after lumpectomy three weeks,ago. I had a lot of anxiety after reading various comments about how painful the blue dye injections were before. Not so. The Dr. said it would feel like a bee sting...more like a mosquito bite in my opinion...if you are having this done, do not fret.nothing to it. I do have incision pain today, but I know that will be better tomorrow.
      Cindy in Salem, Oregon

      over 2 years ago
    • ld_105's Avatar
      ld_105

      I had everything done on the same day. The wires, the injection, and then into surgery.
      Sorry swimmer but the injection hurt like heck. Right into the nipple. However the placement of the injection was necessary because of the two tumors, one on top of the breast and one under. No one told me about it before surgery. Just as well as I would only have worried more. I have completed five years of Arimidex and have my last doctor's appointments next week. Thank goodness.

      over 2 years ago
    • PaulineJ's Avatar
      PaulineJ

      ld_105
      Funny how I heard years after that they numbed the area to someone I know.I had to go through it without being numbed.(I'm not going to make lt of the pain) It was extremely painful.

      over 2 years ago

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