Very informative. I have one out of 6 lymph nodes positive. Will be doing 4 rounds of TC Chemo, 3 weeks of radiation and anti- hormone tablets for 7 years. Really hoping that I become breast cancer free and it remains that way.
Starting your treatment plan with clear steps forward is a positive move towards managing your breast cancer. It sounds like you have a comprehensive treatment plan in place. Staying hopeful and closely monitoring your health with your medical team will support the best possible outcomes.
I had the injection of dye right down in my nipple. So painful! A computer in surgery was able to guide my surgeon in removing them! I had 21 nodes removed and 19 were positive. One node from left armpit removed and was negative. After double mastectomy, removal of lymph nodes, I had reconstruction! 8 hours! I refused chemo and had 27 radiation Burns. On anastrozole 1 mg q day. Finishing 4th year. Biggest problem is fatigue. Slight lymphedema to arm! Doing well! HR+ HER2 neg
I've recently had a Lumpectomy with an unclear margin (DCIS) and two nodes removed, one positive (at the start of the node). I'll be have surgery in a few weeks to remove further nodes. Thank you for explaining.
Thanks for the video. I am currently undertaking immunotherapy after an esophagectomy for esophageal cancer. During the operation the surgeon mentioned that he cut out a couple of cancerous lymph nodes hence I was put on immunotherapy alas though, my oncologist informed me that there is a mass in my abdomen which contains some suspicious lymph nodes which need a biopsy. I'm pretty positive I'm sure if it was cancer then the immunotherapy would have caught it and destroyed it. Just to be on the safe side I will have a PET scan as well to see if its spread into another organ.
I’m sorry! I had a lumpectomy and two lymph nodes removed August 2022. I’m currently taking Letrozole (anti-estrogen for women past menopause). My medical oncologist wants me to now start on Abemaciclib (Verzenio). This seems to be the normal protocol from what I’ve read and watched. Everything is done in stages. What no one can tell me is, how much this drug will cost me monthly. I have to wait until my insurance approves the drug. Then I have to wait for a “specialty” pharmacy to call to tell me the drug has been approved and what my co-pay will be. IF I can afford it, I will have to pay for it before they send it to me. If I can’t afford it, I will just refuse it, and go on living without it. If I were old enough to be on Medicare, my team has a grant program to pay for all of it. I’m okay with that. If I were on Medicaid, it would be free to me covered by our tax dollars. I’m not okay with that. The drug has a list price of $15,000 per month! It is recommended to be taken for 1-2 years. I’m sorry for being so winded, and I don’t want to scare you. You may not even need to take these drugs because you had a mastectomy. I just think women should be aware of what may come after their surgery. The side effects are not pleasant either.
We can only imagine how challenging this must be for you. Thank you for sharing your experience with the Yerbba community. Keep coming back for more content. We know many people who remain cancer free many years later even with a high number of positive lymph nodes.
My Mom had 3 levels of axillary dissection level1 had 3 out of 12 positive. Level2 had 1 out of 7 positive and Level 3 had only 1 tiny node which was neg.but since it was 4 out of 20 positive. She was classified as yct3nomo to ypt3n2mo for lobular cancer.how is prognosis dr.also there was mention of extracapisular spread.but in all this there was no mention of isolated cells or size of the lymph nodes whether it was micro or macroscopic spread.shd it be tested again to get the details
Thanks for writing. With this number of positive lymph nodes, it is very likely that radiation therapy will be recommended. In other words, she will likely be offered the most treatment available. The extra-capsular extension just means that radiation therapy is likely to be recommended, which it would likely be because of the number of lymph nodes. In terms of prognosis, there are several other key features that will determine her prognosis. It is very likely that she will do well! Wishing you both the best.
It's not clear why someone would have more pain in one surgery site than in another. Most people find that their pain decreases over time. If the pain is interfering with your quality of life, seeking treatment is a good idea.
I will soon see my oncologist. I have undergone bilateral mastectomy. 1 breast had IDC mass of 1.7 x 1.5 x 1 cm AND one DCIS close by…(7 o’clock/6 o’clock respectively) I also had Macro-metastasis in 1out of 4 sentinel lymph nodes that were checked. I had a good negative margin around my cancers. In my opposite breast I had pre-cancerous (hyperplasia?? Lesions?) and was told I had made a great decision in having them both removed. ER+ HER2-, Ki67 is 15%, and oncotype is 22. Will I be offered chemo, radiation &/or hormone blockers or inhibitors? I just can’t find much on Macro vs Micro metastatic lymph node findings. I am post menopausal. I’ve watched all your videos and so respect your teachings. My oncologist appointment is coming soon and I want to give it my best shot now because I am active and healthy right now to give it a good fight.
Thanks for writing. The only distinction between micro- and macrometastases is the size. If a lymph node focus (area) is large enough to make it not a micrometastasis, we just call it a metastasis. So it sounds as if you have one positive lymph node out of the 4 that were removed. It is likely that your doctor and you will have a discussion about whether chemotherapy is in accord with your values and preferences. Many people with these features would not get chemotherapy. Endocrine therapy is warranted in people with a tumor like this. You may be referred to a radiation oncologist, but in general, radiation therapy after mastectomy is most beneficial in premenopausal people with 1 to 3 nodes.
I had a DMX after ILC diagnosis, clear margins, 4 hot nodes removed. Stage 1A. The pathology report showed 3 were not lymphatic tissue and the one had micrometastases of .3mm focus. I was told I have very few lymph nodes and radiation is not necessary. I am on Letrozole. I am not clearly understanding why radiation was not prescribed. Can you explain? I'm 73.
Radiation can be omitted in people with smaller tumors who are over 70 with hormone receptor-positive, HER2-negative cancer with wide margins. After mastectomy, radiation therapy is not recommended unless lymph nodes are clearly positive, the tumor is over 5 centimeters, or margins are close. We hope this is helpful.
Thank you for all of your informative videos! I had SLNB during lumpectomy in 2015 for TNBC. One out of three had micrometastasis. Was given 33 rads. Two weeks ago I had same side mastectomy after 4 mm IDC TNBC, attempted SNLB with blue dye and technetium. However, no nodes became blue or reacted to the wand, no suspicious nodes upon palpation. None taken. How common is this after previous SLNB? Not sure how worried I should be. Tx at Rush Chicago.
Right after surgery, it is not uncommon to feel some bumpiness on the breast, chest wall, or in the armpit (axilla). If there is pain or fullness, it is worth reaching out to your mother's surgeon.
Sure! The radioisotope is concentrated in the sentinel node (or nodes, generally 1-4 nodes). Then the surgeon uses a tool that detects the "hot" node and proceeds to remove the 1-4 nodes that are hottest.
@@yerbba Are these nodes then examined by a pathologist in the OR at the time of the surgery? Are the radioacive glands the only ones to be removed, is this an indication that there will be cancer cells in them? Thank you
@@paigemckelvey8781 when my nodes were removed during surgery, they were sent to pathology. I didn’t receive the results for several days. Mine contained cancer. Read my comment above.
Thank You Can I ask a question please My histology report on lymph nodes states- metastatic carcinoma 5of9 240 extra scapular extension present. Does this mean higher risk of local recurrence. Kindest regards
Good question. Extracapsular extension is associated with a higher risk of local recurrence. The key is that the treatment options will not change because the positive lymph nodes will drive your treatment recommendations. I hope this is helpful.
Thank you so much for this video! I had a bilateral mastectomy with sentinel lymph node biopsy. Three nodes were removed and the first lymph node showed that the cancer started to enter but it was encapsulated. Does this mean the cancer most likely stopped moving through the lymph nodes at that point or could it still have spread. Would you recommend chemo for this? I plan on doing radiation, tamoxifen and prophylactic removal of ovaries. I am stages 2B because one node was involved and the tumor in tbe breast was 2.5cm. I am ER/PR + HER2- but carry the BRCA1 gene
It is hard to make recommendations about your case in particular without being part of your medical team. People with Stage II (2) breast cancer are often advised to have chemotherapy because chemotherapy has a greater benefit than in people with lower stage disease all other things being equal.
Hi Dr. I had/have stage 2 breast cancer trip negative. I had a double mastectomy and a sentinel. All my lymph nodes were negative. Please explain the procedure forward
Thanks for writing. It's difficult to know the exact treatment plan in your case. Some considerations that people in your situation may hear about include chemotherapy, targeted therapy, radiation therapy depending on the tumor size. Some people may also be offered a re-excision if one or more of the margins are close.
Calcium can mean several things depending on the appearance of the calcifications and the treatment that's been given. Your medical team can help you interpret these findings. It may mean that there is cancer in the lymph node, and it's important to know that benign (non-cancerous) conditions can lead to calcifications too.
Is it standard procedure to have the radiation injected under the nipple(s) without any pain reliever or sedative prior to even going back to be prepped for surgery? I went to a medical center that includes radiology to have the injection, and then I was driven to the surgical center for my surgery. I went in in a very positive, upbeat mood, only to come out crying like I’ve never cried before because the pain was so horrendous! After the injection, I felt like the inside of my breast was on fire. I nearly hit the ceiling, the pain was so intense! Later, I found out that my surgeon didn’t want me to be given anything that would interfere with drugs they would have to give me during surgery.
@@yerbba I had this injection in February of this year the day before my lumpectomy was scheduled. When I got there they did explain that they wouldn't be give me any pain relief and that it was going to hurt but would be over with quickly. I thought I was prepared but it felt like a nuclear explosion went off in my breast. However, it faded rapidly and never bothered me again. My cousin, who had been diagnosed with the same exact breast cancer two days after me had a different medical team and hospital and they gave her four injections for pain relief around her nipple before doing this. That area ended up so badly bruised by the four injections that it hurt her worse than her subsequent lumpectomy and went on for weeks. So I guess it's a six of one/half dozen of another type of situation. Just one of those things that's not really fun no matter how you do it but necessary.
Having enlarged lymph nodes and a lump in each breast should be evaluated by a medical professional. It's hard to say what is causing the findings without having the ability to do an exam and take a good history. Wishing you all the best.
Dear doctor, my sister have enlarged lymph nodes with negative FNAC result and fibroadenoma... should she undergo surgery to remove these and do biopsy again
It's hard to make specific recommendations without being part of your sister's medical team. Definitely worth asking these important questions. Your sister is fortunate to have you.
Is it possible to have negative sentinel lymph nodes but positive lymph nodes? In other words, somehow cancer skips the sentinel lymph nodes and spreads?
Thank you for your comment. Lymph nodes are throughout the entire body and are perfectly normal. If you are noticing pain or irregular lymph nodes, it's recommended to talk to your medical team.
Internal mammary lymph nodes do "upstage" the cancer such that, if the internal mammary nodes are positive by imaging, having such a node will make the lymph node stage N1b or N2b. All that being said, these nodes are usually included in the radiation therapy field. They are not really dangerous in terms of how they affect the patient.
Let’s talk about prevention first. Having an Iodine deficiency will cause breast cysts and eventually cancer, if your Iodine levels are not corrected. Even if you do develop breast cysts, start Iodine drops and Selenium immediately, and your cysts will disappear. It’s not rocket science.
Thanks for sharing your thoughts. It's important to clarify that cysts do not become cancer. There is some interesting epidemiologic work that links iodine deficiency to breast cancer, but there are no studies showing that iodine prevents breast cancer (in clinical trials for example).
Very informative. I have one out of 6 lymph nodes positive. Will be doing 4 rounds of TC Chemo, 3 weeks of radiation and anti- hormone tablets for 7 years. Really hoping that I become breast cancer free and it remains that way.
Starting your treatment plan with clear steps forward is a positive move towards managing your breast cancer. It sounds like you have a comprehensive treatment plan in place. Staying hopeful and closely monitoring your health with your medical team will support the best possible outcomes.
I had the injection of dye right down in my nipple. So painful! A computer in surgery was able to guide my surgeon in removing them! I had 21 nodes removed and 19 were positive. One node from left armpit removed and was negative. After double mastectomy, removal of lymph nodes, I had reconstruction! 8 hours! I refused chemo and had 27 radiation Burns. On anastrozole 1 mg q day. Finishing 4th year. Biggest problem is fatigue. Slight lymphedema to arm! Doing well! HR+ HER2 neg
Thank you for sharing your experience with our community. Wishing you the best moving forward.
I've recently had a Lumpectomy with an unclear margin (DCIS) and two nodes removed, one positive (at the start of the node). I'll be have surgery in a few weeks to remove further nodes. Thank you for explaining.
Thanks so much for watching.
Best explanation I have heard!
Thank you for your positive comment and for watching.
Thanks for the video. I am currently undertaking immunotherapy after an esophagectomy for esophageal cancer. During the operation the surgeon mentioned that he cut out a couple of cancerous lymph nodes hence I was put on immunotherapy alas though, my oncologist informed me that there is a mass in my abdomen which contains some suspicious lymph nodes which need a biopsy. I'm pretty positive I'm sure if it was cancer then the immunotherapy would have caught it and destroyed it. Just to be on the safe side I will have a PET scan as well to see if its spread into another organ.
Thanks for sharing your story. Wishing you all the best.
I had a few removed & masectomy last tues💗
I’m sorry! I had a lumpectomy and two lymph nodes removed August 2022. I’m currently taking Letrozole (anti-estrogen for women past menopause). My medical oncologist wants me to now start on Abemaciclib (Verzenio). This seems to be the normal protocol from what I’ve read and watched. Everything is done in stages. What no one can tell me is, how much this drug will cost me monthly. I have to wait until my insurance approves the drug. Then I have to wait for a “specialty” pharmacy to call to tell me the drug has been approved and what my co-pay will be. IF I can afford it, I will have to pay for it before they send it to me. If I can’t afford it, I will just refuse it, and go on living without it. If I were old enough to be on Medicare, my team has a grant program to pay for all of it. I’m okay with that. If I were on Medicaid, it would be free to me covered by our tax dollars. I’m not okay with that. The drug has a list price of $15,000 per month! It is recommended to be taken for 1-2 years. I’m sorry for being so winded, and I don’t want to scare you. You may not even need to take these drugs because you had a mastectomy. I just think women should be aware of what may come after their surgery. The side effects are not pleasant either.
Sending good energy your way. Thanks for watching.
I had 49 lymph nodes removed from my left axilla and 44 were positive.
We can only imagine how challenging this must be for you. Thank you for sharing your experience with the Yerbba community. Keep coming back for more content. We know many people who remain cancer free many years later even with a high number of positive lymph nodes.
My Mom had 3 levels of axillary dissection level1 had 3 out of 12 positive. Level2 had 1 out of 7 positive and Level 3 had only 1 tiny node which was neg.but since it was 4 out of 20 positive. She was classified as yct3nomo to ypt3n2mo for lobular cancer.how is prognosis dr.also there was mention of extracapisular spread.but in all this there was no mention of isolated cells or size of the lymph nodes whether it was micro or macroscopic spread.shd it be tested again to get the details
Thanks for writing. With this number of positive lymph nodes, it is very likely that radiation therapy will be recommended. In other words, she will likely be offered the most treatment available. The extra-capsular extension just means that radiation therapy is likely to be recommended, which it would likely be because of the number of lymph nodes. In terms of prognosis, there are several other key features that will determine her prognosis. It is very likely that she will do well! Wishing you both the best.
I just had both breast removed but my right hurts worse than the left why
It's not clear why someone would have more pain in one surgery site than in another. Most people find that their pain decreases over time. If the pain is interfering with your quality of life, seeking treatment is a good idea.
thank you for your helpful and educational information.
We appreciate your support!
Great explanation, thank you! Love your newer glasses.
Thank you for watching and your kind comment. A completely different look!
excellent explanation!
Thanks for watching!
I will soon see my oncologist. I have undergone bilateral mastectomy. 1 breast had IDC mass of 1.7 x 1.5 x 1 cm AND one DCIS close by…(7 o’clock/6 o’clock respectively) I also had Macro-metastasis in 1out of 4 sentinel lymph nodes that were checked. I had a good negative margin around my cancers. In my opposite breast I had pre-cancerous (hyperplasia?? Lesions?) and was told I had made a great decision in having them both removed. ER+ HER2-, Ki67 is 15%, and oncotype is 22. Will I be offered chemo, radiation &/or hormone blockers or inhibitors? I just can’t find much on Macro vs Micro metastatic lymph node findings. I am post menopausal. I’ve watched all your videos and so respect your teachings. My oncologist appointment is coming soon and I want to give it my best shot now because I am active and healthy right now to give it a good fight.
Thanks for writing. The only distinction between micro- and macrometastases is the size. If a lymph node focus (area) is large enough to make it not a micrometastasis, we just call it a metastasis. So it sounds as if you have one positive lymph node out of the 4 that were removed. It is likely that your doctor and you will have a discussion about whether chemotherapy is in accord with your values and preferences. Many people with these features would not get chemotherapy. Endocrine therapy is warranted in people with a tumor like this. You may be referred to a radiation oncologist, but in general, radiation therapy after mastectomy is most beneficial in premenopausal people with 1 to 3 nodes.
I had a DMX after ILC diagnosis, clear margins, 4 hot nodes removed. Stage 1A. The pathology report showed 3 were not lymphatic tissue and the one had micrometastases of .3mm focus. I was told I have very few lymph nodes and radiation is not necessary. I am on Letrozole. I am not clearly understanding why radiation was not prescribed. Can you explain? I'm 73.
Radiation can be omitted in people with smaller tumors who are over 70 with hormone receptor-positive, HER2-negative cancer with wide margins. After mastectomy, radiation therapy is not recommended unless lymph nodes are clearly positive, the tumor is over 5 centimeters, or margins are close. We hope this is helpful.
You really help me with informative video, that's why I subscribe.
Thank you so much for being part of our community!
Thank you for all of your informative videos! I had SLNB during lumpectomy in 2015 for TNBC. One out of three had micrometastasis. Was given 33 rads. Two weeks ago I had same side mastectomy after 4 mm IDC TNBC, attempted SNLB with blue dye and technetium. However, no nodes became blue or reacted to the wand, no suspicious nodes upon palpation. None taken. How common is this after previous SLNB? Not sure how worried I should be. Tx at Rush Chicago.
Thanks for writing. While this isn't common, it also is not rare. Wishing you the best as your go through your treatment.
Dear doctor, my mum had a bump on the axillary after masectomy and lymph jode removal. Is this normal?
Right after surgery, it is not uncommon to feel some bumpiness on the breast, chest wall, or in the armpit (axilla). If there is pain or fullness, it is worth reaching out to your mother's surgeon.
@@yerbba thank you for your explanation we hope many people are blessed through your channel
Thank you, excellent discussion
Thank you for the kind words!
I wonder if you can comment on the use of Radioactive isotopes and how they determine which nodes to remove during surgery? thank you
Sure! The radioisotope is concentrated in the sentinel node (or nodes, generally 1-4 nodes). Then the surgeon uses a tool that detects the "hot" node and proceeds to remove the 1-4 nodes that are hottest.
@@yerbba Are these nodes then examined by a pathologist in the OR at the time of the surgery? Are the radioacive glands the only ones to be removed, is this an indication that there will be cancer cells in them? Thank you
@@paigemckelvey8781 when my nodes were removed during surgery, they were sent to pathology. I didn’t receive the results for several days. Mine contained cancer. Read my comment above.
Thank You
Can I ask a question please
My histology report on lymph nodes states- metastatic carcinoma 5of9 240 extra scapular extension present.
Does this mean higher risk of local recurrence.
Kindest regards
Good question. Extracapsular extension is associated with a higher risk of local recurrence. The key is that the treatment options will not change because the positive lymph nodes will drive your treatment recommendations. I hope this is helpful.
Very informative
Thank you for watching and the positive feedback.
Thank you so much for this video! I had a bilateral mastectomy with sentinel lymph node biopsy. Three nodes were removed and the first lymph node showed that the cancer started to enter but it was encapsulated. Does this mean the cancer most likely stopped moving through the lymph nodes at that point or could it still have spread. Would you recommend chemo for this? I plan on doing radiation, tamoxifen and prophylactic removal of ovaries. I am stages 2B because one node was involved and the tumor in tbe breast was 2.5cm. I am ER/PR + HER2- but carry the BRCA1 gene
It is hard to make recommendations about your case in particular without being part of your medical team. People with Stage II (2) breast cancer are often advised to have chemotherapy because chemotherapy has a greater benefit than in people with lower stage disease all other things being equal.
Hi Dr. I had/have stage 2 breast cancer trip negative. I had a double mastectomy and a sentinel. All my lymph nodes were negative. Please explain the procedure forward
Thanks for writing. It's difficult to know the exact treatment plan in your case. Some considerations that people in your situation may hear about include chemotherapy, targeted therapy, radiation therapy depending on the tumor size. Some people may also be offered a re-excision if one or more of the margins are close.
What does it mean that calcium was found in a right armpit lymph node?
Calcium can mean several things depending on the appearance of the calcifications and the treatment that's been given. Your medical team can help you interpret these findings. It may mean that there is cancer in the lymph node, and it's important to know that benign (non-cancerous) conditions can lead to calcifications too.
well done
Thanks for watching and your comment.
In Lobular Breast cancer can the sentinel axillary nodes be negative and the supraclavicular positive?
Although this is uncommon, it is possible, yes.
Is it standard procedure to have the radiation injected under the nipple(s) without any pain reliever or sedative prior to even going back to be prepped for surgery? I went to a medical center that includes radiology to have the injection, and then I was driven to the surgical center for my surgery. I went in in a very positive, upbeat mood, only to come out crying like I’ve never cried before because the pain was so horrendous! After the injection, I felt like the inside of my breast was on fire. I nearly hit the ceiling, the pain was so intense! Later, I found out that my surgeon didn’t want me to be given anything that would interfere with drugs they would have to give me during surgery.
Wow I didn't know the injection will be painful! Sorry to hear. This is something I need to ask the surgeon then.
Oh I know it is so painful surly do when in surgery and knocked out 😢
Many people have told me that they are not prepared for this experience. We hope you are feeling better.
@@yerbba Thank you! I am feeling much better, but still fighting the fight.
@@yerbba I had this injection in February of this year the day before my lumpectomy was scheduled. When I got there they did explain that they wouldn't be give me any pain relief and that it was going to hurt but would be over with quickly. I thought I was prepared but it felt like a nuclear explosion went off in my breast. However, it faded rapidly and never bothered me again. My cousin, who had been diagnosed with the same exact breast cancer two days after me had a different medical team and hospital and they gave her four injections for pain relief around her nipple before doing this. That area ended up so badly bruised by the four injections that it hurt her worse than her subsequent lumpectomy and went on for weeks. So I guess it's a six of one/half dozen of another type of situation. Just one of those things that's not really fun no matter how you do it but necessary.
Hi... how are you? I have a question... What does it mean if you have swollen lymphnodes and lump on each breast?
Having enlarged lymph nodes and a lump in each breast should be evaluated by a medical professional. It's hard to say what is causing the findings without having the ability to do an exam and take a good history. Wishing you all the best.
Dear doctor, my sister have enlarged lymph nodes with negative FNAC result and fibroadenoma... should she undergo surgery to remove these and do biopsy again
It's hard to make specific recommendations without being part of your sister's medical team. Definitely worth asking these important questions. Your sister is fortunate to have you.
Is it possible to have negative sentinel lymph nodes but positive lymph nodes? In other words, somehow cancer skips the sentinel lymph nodes and spreads?
Yes
Yes I had this
Yes, that can happen occasionally.
Great question! Thank you for asking.
I have lymph nodes in my neck and near to ears... is it cancer?
Thank you for your comment. Lymph nodes are throughout the entire body and are perfectly normal. If you are noticing pain or irregular lymph nodes, it's recommended to talk to your medical team.
Are intramammary nodes dangerous?
Internal mammary lymph nodes do "upstage" the cancer such that, if the internal mammary nodes are positive by imaging, having such a node will make the lymph node stage N1b or N2b. All that being said, these nodes are usually included in the radiation therapy field. They are not really dangerous in terms of how they affect the patient.
Thank you for explaining because my margin was not clear in my other breast.
I need another surgery to remove some.
Thanks for watching, and we're happy this was helpful.
❤
Thank you for watching!
Let’s talk about prevention first. Having an Iodine deficiency will cause breast cysts and eventually cancer, if your Iodine levels are not corrected.
Even if you do develop breast cysts, start Iodine drops and Selenium immediately, and your cysts will disappear. It’s not rocket science.
Thanks for sharing your thoughts. It's important to clarify that cysts do not become cancer. There is some interesting epidemiologic work that links iodine deficiency to breast cancer, but there are no studies showing that iodine prevents breast cancer (in clinical trials for example).