I'd never heard about lymph nodes that re grow, or new ones being formed. Just assumed we had a fixed amount of them in our bodies. Learn something new every day! Thank-you Dr. Jen.
I never did either, and they weren't taking them out if they really don't have to. When they take em out it's brutal it's worse than the cancer you end up with lympheadema so I never heard they grew back. It's your immune system!?
It's amazing what our bodies are capable of! While the lymph nodes that have been removed won't grow back, your body will "recruit" additional lymph nodes.The lymphatic system is incredibly adaptable.
Thank you!! Your videos explain things in much more detail than my doctor has time to do. I love my onc but there's just never enough time to cover everything and your videos really help fill the gaps.
"the body can produce extra lymphoid tissue" ? that is something i would like to know more about. Its such an amzing system.Never knew i had it , until it got 'broken' and lost a few due to cancer. Living with lymphoedema gets easier the more i learn and understand why i need to do , what i have to do , to keep swelling down and slow fibrosis.
My surgeon did not recommend removing lymph nodes for testing because I was stage 1 and grade 1, ER positive and am 73 years old. I was told, in my case, the risks outweighed the benefits. I had a lumpectomy with clean margins. I hope it was not a mistake to not test the lymph nodes. Thank you for your very informative videos!
Thanks for writing. In general, for people over 70 years of age with a tumor like the one you're describing, there is compelling evidence that lymph node assessment is not necessary.
@@yerbbahow about people with the same type of breast cancer stage 2 with axillary lymph nodes (1) involvement, should I get removed them and do radiotherapy?
Thank you . Very informative . I now understand my breast cancer better . I was stage one . I did surgery , chemo , and radiation . I was HER 2 positive . I will be taking pills . I have genetic risk of recurrence. That is why aggressive treatment was chosen . Thank you .
We're so glad our videos have been helpful for you to understand your breast cancer better. With your stage one diagnosis and HER2 positive status, it's great that you're following a comprehensive treatment plan to manage the genetic risk of recurrence. Keep up the proactive approach to your health. Thanks for watching!
I'm a year and 6mths cancer free I had 2 sessions of the green chemo my immune system crashed however I did have 6 sessions of radiation therapy that went well.. stradexa I took for 2and half mths this did not bid me well so discontinued talking it....I was Her2 N EP and PP ....I have a family history of blood clots and heart failure so far I'm healthy I'm 61 this year . Goodness I have so much to tell feel like I'm in therapy 😊thank you sooo much you've answered all my questions in this clip...I keep my diet clean and green also lots of protein...thank you for this platform .. 😊
You're very welcome! We're glad to hear that you found the information helpful, and it's great to know that you're a 1.5 years cancer-free. Your proactive approach to maintaining a healthy lifestyle with a clean and green diet is commendable. Thank you for being part of the Yerbba community!
Thank you for your question. Extranodal extension is associated with a higher risk of recurrence, which is why we give radiation therapy. In someone with positive lymph nodes, with or without extranodal extension, radiation therapy is considered.
@@yerbba I appreciate that you answered my question. I’ve had surgery, radiation and I’m on anastrozole. 1 lymph node positive and clean margins. Oncotype was 14. Before this I thought I had 20-30 more years but now I take one day at a time!
My pathology report noted both extranodal extension and lymphovascular invasion (Stage 3, 11 positive nodes because the original tumor was actually under my arm, not on the breast) Because of this location I just assume I have a high risk of recurrence. Would I be able to stay on a targeted therapy long-term??
@yerbba Thank you so much for this video . I do watch regularly your videos and they give a lot of information as well as they do give positive vibes for questions in mind and hope .
Your videos are incredibly helpful, thank you! It would be nice if you could teach us what to expect when we stop letrozole after 10 years of treatment. Will I feel better, and if so how?
This is a great question. One would expect that any side effects from the medication will resolve and go away after a couple of weeks to a couple of months. Most people find the hot flashes and similar side effects get better first.
Thank for another informative video. A couple of questions - if a sentinel node biopsy is negative following chemotherapy and the surgery does that indicate recurrence is unlikely. Secondly I was injected with radioactive blue material injected directly into my breast prior to surgery. I understood that was to help the surgeon find the lymph nodes. I’d like to understand more about that as I took from your video that it is the pathologist who finds them. Thanks
We'll start with your second question first. The surgeon identifies the node or nodes that take up the blue dye or, in some people, the radioisotope, by looking at the lymph node with the naked eye. The pathologist is the one that identifies the actual nodal tissue and whether or not the lymph node(s) is or are positive under the microscope. Sometimes the lymph node may be enlarged or hard, both of which may indicate that the lymph node is likely to have cancer. For your second question, a negative lymph node after chemotherapy is a good sign, but the amount of tumor in the breast is also important in helping estimate a prognosis.
So helpful! Thank you!! I wonder though if vigorous exercise forces cancer in lymph nodes to spread more quickly? It seems like it would get things flowing through the lymphatic and blood stream more readily.
Any cells in the lymph nodes are well embedded in the tissues. As far as we know, vigorous exercise does not dislodge cancer cells from the lymph nodes.
Great video, thank you for this! I had lumpectomy for my Er+ BC, stage 1a, with two sentinel lymph nodes taken out and pathology found no cancer cells in them. However, I would like to know,if no cancer cells were found in those two sentinel nodes, is there a possibility that in axillary lymph nodes ( if they were taken out but they did not) there would be some cancer cells? From your video I understood that they can pass some lymph nodes and go in others?
Good question. It is unlikely that someone with negative sentinel lymph nodes would have other lymph nodes that are positive. In someone with clinically negative lymph nodes (non-palpable, no enlargement or other abnormality on imaging studies), the likelihood that this would happen is very low.
Had sentinel lymph node biopsy with lumpectomy, all imaging prior showed benign nodes. Now dealing with cording and lymphedema, I'll have to live with a swollen arm and hand the rest of my life with constant physiotherapy appointments.
Have you gone on line and check out the message therapies to do and the Ti chi versions this im told is the only hope with lymphedema.... I have a problem as well, but it's weird sensations and extremely weak, and I was very strong, now 2 pounds feels like 30pds. Good luck , and praying helps .
excellent video. Very informative! I'm curious about positive supraclavicular nodes. I have one positve. The few statistics that I can find are quite grim. Do you talk more in depth about these specific nodes and the role they play in any of your other videos? Thank you!!
Great question. Supraclavicular lymph nodes used to be classified as Stage IV disease. Then it was found that many people were being cured with systemic therapy and radiation therapy. This led to supraclavicular lymph nodes being reclassified as N3 and the overall stage as IIIc (3C). Yes, this is a serious illness but not without hope of cure.
Does breast cancer spread through circulation or lymphatic system more? I have seen studies debating on this saying that the LNs filter, not spread cancer and that lymph nodes don't metastasize and rather that it comes though the blood system more. Would love to hear an education program on this topic.
It is interesting, isn't it? Studies have shown that 4 or more nodes does make a real difference in terms of prognosis. But of course, the fewer the better. Thank you for watching.
Hi Dr.I had stage 2b breast cancer 30.5 years ago.One lymph node had a small amount of cancer in one node.I had a lumpectomy,chemo,and radiation.In March of 2020 i was diagnosed with stage 3 breast cancer.Advanced,after having a no evidence of disease letter sent 3 months before this! Cancer is sneaky!
How are you now deborah? I’m also diagnosed with invasive ductal stage 1 grade 2. After Mri was called in, I found out that 2 of my lymph nodes are enlarged. Do I need to be concerned that my cancer has spread in my lymph nodes?
I actually had a lumpectomy first,2.0 centimeter in late 93.With one to several lymph nodes involved you should be o.k.,with proper treatment.Mine recurred in the axillary area,and skin which is a more serious condition.
Thank you for opening up about your incredible journey. Facing stage 2b breast cancer and now navigating through a stage 3 diagnosis after a period of no evidence of disease must have its own challenges. We're here alongside you, and if there's anything more specific you'd like to learn about, please let us know.
@yerbba Dr.Griggs thank you for all that you do to help us understand breast cancer.After having 18 lymph nodes removed,and only a small amount in one 30.5 yrs.ago.I thought I wouldn't ever have a concern in my axilla area.So 4 yrs.ago the cancer recurred as a 1.5 cm.tumor,with an inch of skin involvement.What a surprise since it was not in my lymph nodes.Anyway,I did have radiation with 10 boost extra,because of not having clear margins in Nov.93.Thank you again for helping everyone on here.
We're not quite sure what you mean and we agree that doctors need to be honest with their patients. Some patients do not want the "whole truth," so it's important for doctors to ask what type of information the patient wants.
Hi Dr, thanks for this video. I currently have stage 2 with a 4.5 CM tumor with 1 positive lymph node. I am 40 years old. My doctor says that because of my age they recommend Chemo regardless of my oncotype score. I was wondering your opinion on that? I’ve done a lot of research and I haven’t found anybody mentioning that being young (40 years old) is a definite benefit to chemo regardless of Oncotype until my doctor mentioned it. My cancer is Hormone positive and Her 2 negative. Would love to hear your thoughts on my age as a deciding factor for deciding on chemo? Thank you!
Age plays a role in chemotherapy decisions once an OncotypeDX score is back. For people who are younger, a lower score will often lead to a recommendation for chemotherapy. But without an OncotypeDX score, you are right, age no longer plays an independent role in chemotherapy recommendations.
Thanks for the question. There is no relationship between sciatica and cancer unless someone has recurrent cancer that compresses the sciatic nerve. This is extremely uncommon.
Is the pathologist working in the same surgery room together with the surgeon while we are having the surgery meaning that the surgeon is receiving the information so he/she knows how to proceed with the lymph nodes? I know it’s a long question but I am very curious about it. Thank you!!
The pathologist is rarely in the operating room with the surgeon. Space limitations and concerns about maintaining a sterile environment make it difficult to add in another person with the required equipment. In places where the pathologist and operating room are near one another, the sharing of information is seamless and prompt.
Tha k you so much, I wish I had this information in 2020 from my surgeon and oncologist . Informative, but , I have more questions ... Good luck to everyone with any type of diseases😎🙏
Great question. This finding on imaging may mean that there are cancer cells in these lymph nodes. In general, the treatment given for the other sites in the body will treat these lymph nodes as well.
Thanks for the info . Do I have to worry about lymph nodes at the end of my jaw line ? It developed during my chemo sessions . Also my sentinal lymph node is clear .
It would be worth showing your doctor the lymph node that you're noticing. This is not a typical place where lymph nodes show up related to breast cancer, but it never hurts to check.
Thank you Doctor. May i ask, would you mind telling us more about how lymph nodes work and how cancer cells go about reprogramming the nodes over time to see the cancer as "friendly"? I just had an 80 x 50 x 60 mm tumour removed from my breast, with one node having a macro-metastasis of >10mm (but no extrusion escaping through the node wall). At what point do cancer cells reprogramme the lymphatic system to see cancer as "friend" and therefore no longer send cells to attack the tumour? When one node has been reprogrammed, and lets tge cancer basically claim squatters rights, live in there, and reproduce in the node: does that mean the whoke lymphatics system has come to see that particular cancer as "friendly" and so won't attack it in future? Is this how lobular carcinoma manages to lay down micro-metastases early, and our bodies reach a point where our TNFactor and the various immune cells then won't attack those micrometastases?
Good questions, and there is of course a lot of interest in these questions. It's important to differentiate between the lymph nodes and the immune system. The lymphatic system is only part of the immune system. Immune cells are present throughout the body, including the blood and the tissues themselves.
I've got a sudden appearance of a lump in my right breast which can be seen as rather a large lump on digital photos I took..I've had painful lymph nodes under my right armpit for around 1 month..severe Shingles I got early September and I'm extremely tired with a red rash over the right breast plus in between which doesn't go away..Im 52 and it is also painful on my right side near the armpit..Im going back to the doctors in a day..Any thoughts?please..😐😒
Thanks for writing. Without being part of your medical team and having the ability to examine you, it is difficult to render an opinion. The best guidance we can give is to see your doctor soon.
Thank you for sharing. It's important to give yourself grace during this time and focus on your healing. Make sure to follow your healthcare team's advice closely, stay hydrated, and rest as much as possible. Wishing you a smooth and gentle recovery.
Facing a diagnosis of stage 3C triple-negative breast cancer (TNBC) is undeniably a significant challenge. It's completely normal to feel a range of emotions, including difficulty in acceptance. Remember, you're not alone in this. There is a community of support here for you. Thank you for watching.
Hello, I had many nodes removed from my left arm and armpit (due to cancer), and thought the few healthy nodes would duplicate. I asked my Oncologist if they woud and was told no ! You mention recruiting lymphoid tissue - how can/does this happen please? Thank you.
Our bodies are amazing, and it's not uncommon for people who have a second lymph node dissection after a complete dissection in the past to have lymph nodes that were not there previously.
How much should the patient or would want to know? Since you talk about lymph nodes why not tell about LVI. Are some cancers of stem cell origin? If so what kills them? Does IHC predict prognosis? If yes, why do favorable IHC outcomes die? What is DCIS? If it’s not a ‘cancer’, why do pure DCIS patients die?
You are asking great questions, and we can sense the emotion behind your questions. Angiolymphatic invasion, also called lymphovascular invasion or LVI, is not related to lymph node status. You may want to check out our video about angiolymphatic invasion here: ua-cam.com/video/VvNRJc7jN6o/v-deo.html There is important work about cancer stem cells and treatments directed against cancer stem cells. For our other viewers, cancer stem cells are a distinct subpopulation within tumors that exhibit stem cell-like properties and are believed to play a crucial role in tumor initiation, progression, and resistance to conventional therapies. It is not possible to determine which cells are stem cells from a tumor. Antibody-drug conjugates and other therapies are offering great promise. Some people with so-called favorable breast cancer can indeed have a recurrence and eventually die from their cancer. You may find our video on why we haven't cured cancer to be helpful: ua-cam.com/video/fLcq25CvtcM/v-deo.html People with pure DCIS who die of breast cancer most likely had invasive cancer that was not detected in the tumor specimen. This is exceedingly rare.
Hello doctor actually im new in canada and im having swolen lymph nodes and i don't know what is this and how can i be treated and is this a stage of breast cancer and i also have pain in my right side of body
Thanks for writing. Without being part of your medical team, it is difficult to know if these lymph nodes are related to cancer and what is causing your pain. If possible, seeing your primary care doctor is likely to be the next best step. If you have a known diagnosis of cancer, your cancer team can also help.
I had 1+ lymph node with favorable tumor grades and did not receive chemo or radiation and 2yrs later I have a regional reoccurrence. I don’t understand
Hello Dr. Griggs, as usual what an excellent informative video. ER/PR+ HER2-, stage 3, single mastectomy, with no lymph nodes involved but surgeon removed a few from my armpit and then other ones were treated with radiation in my collarbone (one year and two months ago). After months of recovery I started having lymphedema in my chest and armpit (swollen and painful), I have been attending lymphedema therapy for more than 6 months already, question is will it ever go away or how does it work? I know each case is different but just to have an idea. A lymphedema video would be helpful too, unless you had already done it and I don’t know? Thank you ❤
Thank you for your kind words. Lymphedema can be challenging, and while it often improves with therapy, it might not completely go away. We have a few lymphedema videos that may offer more insights-you can watch them here! [ua-cam.com/video/rwy00ae40_E/v-deo.html] [ua-cam.com/video/INkM2ZFsNE0/v-deo.html]
The side effects last for a variable amount of time. You may find our video on the duration of chemotherapy side effects helpful. If you have other questions, come back and let us know. ua-cam.com/video/smdh7F_WNYA/v-deo.html
The role of ctDNA is not entirely clear regardless of the stage of disease. There are no studies showing that outcomes are improved in people who have ctDNA testing done.
We understand this must be a concerning time for your friend. It's important to note that while these findings could be related to various conditions, including non-cancerous ones, it's crucial for them to consult with a healthcare professional for a thorough assessment. Encourage your friend to share their concerns and feelings with their medical team, who can provide the necessary guidance and support during this process.
It didn’t seem that you were by stating the size of the tumour and nodes, the 8th edition came out January 2018, there will not be a 9th edition however a 9th version digitally, there’s an app called Oncoassist
I was diagnosed with TNBC, after I fell from stairs and hit my right breast. I bruised and an abcess occured and created a tumor according to my doctor. I never and still don't have any breast cancer or under armpit lymph node symptoms. I was tender, bruised and swollen under my right breast after the fall. Now my doctor wants to do a masectomy diagnosing me with stage 3 TNBC, my underarmpits are not swollen anymore, but he wants to remove all my lymph nodes when I never had any pain or symptoms. Is this normal? I don't want to have lymphadema or any other life threatening illnesses due to a fall.
This sounds really rough. The fall did not cause the cancer, but it certainly got the attention of the doctors! Lymph nodes are examined under the microscope even if there are no symptoms to decrease the risk of recurrence and to help determine the specific treatment plan.
Enlarged lymph nodes can occur for various reasons, and they aren't always a sign of cancer. To learn more, we invite you to watch our video that explores how not all lumps are cancerous: ua-cam.com/video/3TxPRY-CXjY/v-deo.html In very thin people, the lymph nodes can be felt even when benign. Nonetheless, enlarged lymph nodes should be evaluated by a clinician.
I have lymphedema in my right arm due a lot bodes being removed along with my breast . If the lump bodes brow back will my arms swelling go away ? Thank you
Hardened lymph nodes can be a sign that your immune system is responding to something, such as an infection. It’s important to have this checked by your oncologist to determine the exact cause.
My mother recently diagnosed with this, CT scan showing that the tumer not affected any other part of the body, but lymh nodes are affected, due to which, her right arm swell, first cemo session has been done, how long it will take to lymph fluid become normal, and the selling will be reduced?
The swelling is likely related to the surgery. It is important to get treatment for any arm or chest swelling as soon as possible to avoid having such swelling become longstanding. You may want to check out our video on lymphedema here: ua-cam.com/video/rwy00ae40_E/v-deo.html
@@yerbba Thanks for the reply. In the video you mentioned that Lymphedema happened due to after breast cancer treatment / surgery. But in my mothers case, her right arm swell before she diagnosed cancer. We consult with multiple doctors including orthopaedic doctors for the arm issue, and luckily one doctor said this is something else. I can share her biopsy report in personal if needed.
Confused. I have stage 1, level 1. Lumptectomy in 2 weeks when one node will be removed and tested. But if the slow growing tumor has not spread to nodes is radiation needed? Are you saying it can return elsewhere even if prognosis is good?
Radiation therapy is actually given to decrease the risk of recurrence in the breast and neighboring (regional) lymph nodes. Radiation therapy in your case does not decrease the risk of cancer returning in other parts of the body. Even if the surgical margins are clear, radiation therapy decreases the risk of the cancer coming back in the breast after surgery.
@@yerbbathis confuses me. Radiation doesn’t decrease the risk of it reoccurring elsewhere and yet it dii or es decrease the risk of it returning in the same spot. Yet mine is slightly w growing and doc says I have 10!years risk free. At 78 dies radiation make sense? ?
I'd never heard about lymph nodes that re grow, or new ones being formed. Just assumed we had a fixed amount of them in our bodies. Learn something new every day! Thank-you Dr. Jen.
Our pleasure. Our bodies are amazing.
Can I ask is it possible to have a breast lump and lymph node (sentinel area) larger and it not be breast cancer?
@@yerbba I didn't know that. I had 16 of them removed and 14 were involved.
I never did either, and they weren't taking them out if they really don't have to. When they take em out it's brutal it's worse than the cancer you end up with lympheadema so I never heard they grew back. It's your immune system!?
Wow, and I pray your doing well
Wow! They removed all of my lymph nodes on the right side, I didn’t know we could grow more! That’s cool!
It's amazing what our bodies are capable of! While the lymph nodes that have been removed won't grow back, your body will "recruit" additional lymph nodes.The lymphatic system is incredibly adaptable.
Thank you!! Your videos explain things in much more detail than my doctor has time to do. I love my onc but there's just never enough time to cover everything and your videos really help fill the gaps.
Thank you for your kind words. It's heartening to hear that our videos have been a helpful resource for you. We appreciate your support.
"the body can produce extra lymphoid tissue" ? that is something i would like to know more about. Its such an amzing system.Never knew i had it , until it got 'broken' and lost a few due to cancer. Living with lymphoedema gets easier the more i learn and understand why i need to do , what i have to do , to keep swelling down and slow fibrosis.
Our bodies are truly amazing, aren't they? Just like a liver can regenerate, the lymph system can expand and contract as needed.
Thank you for such an informative clip. You truly do have a such a fantastic way of explaining everything.
We truly appreciate the positive feedback! Thank you for being part of the Yerbba community.
My surgeon did not recommend removing lymph nodes for testing because I was stage 1 and grade 1, ER positive and am 73 years old. I was told, in my case, the risks outweighed the benefits. I had a lumpectomy with clean margins. I hope it was not a mistake to not test the lymph nodes. Thank you for your very informative videos!
Thanks for writing. In general, for people over 70 years of age with a tumor like the one you're describing, there is compelling evidence that lymph node assessment is not necessary.
@@yerbbahow about people with the same type of breast cancer stage 2 with axillary lymph nodes (1) involvement, should I get removed them and do radiotherapy?
Thank you doctor for creating this video. These are the answers I was looking for 🙏🏻
We're glad to hear that the video provided the information you were seeking. Thank you for watching!
Thank you . Very informative . I now understand my breast cancer better . I was stage one . I did surgery , chemo , and radiation . I was HER 2 positive . I will be taking pills . I have genetic risk of recurrence. That is why aggressive treatment was chosen . Thank you .
We're so glad our videos have been helpful for you to understand your breast cancer better. With your stage one diagnosis and HER2 positive status, it's great that you're following a comprehensive treatment plan to manage the genetic risk of recurrence. Keep up the proactive approach to your health. Thanks for watching!
I'm a year and 6mths cancer free I had 2 sessions of the green chemo my immune system crashed however I did have 6 sessions of radiation therapy that went well.. stradexa I took for 2and half mths this did not bid me well so discontinued talking it....I was Her2 N EP and PP ....I have a family history of blood clots and heart failure so far I'm healthy I'm 61 this year . Goodness I have so much to tell feel like I'm in therapy 😊thank you sooo much you've answered all my questions in this clip...I keep my diet clean and green also lots of protein...thank you for this platform .. 😊
You're very welcome! We're glad to hear that you found the information helpful, and it's great to know that you're a 1.5 years cancer-free. Your proactive approach to maintaining a healthy lifestyle with a clean and green diet is commendable. Thank you for being part of the Yerbba community!
Good luck with a healthy life 👍
Thank you, Dr. Griggs, for your continuous medical advice.
Thank you for watching!
This has truly been the BEST video I have seen on this topic. Thank you so much!
Thank you so much for your support! We appreciate you!
Many thanks, Dr. Griggs, for this informative video. I never knew most of this and it's reassuring to know that one can grow new lymph nodes.
Thank you for watching. Our bodies are amazing.
Love these videos, have learned alot about my breast cancer.
Thank you for the positive feedback. We appreciate your support!
Can you do a video on extranodal extension and the implication for prognosis in stage 2B, er+, pr+, her2 -? Thank you!
Thank you for your question. Extranodal extension is associated with a higher risk of recurrence, which is why we give radiation therapy. In someone with positive lymph nodes, with or without extranodal extension, radiation therapy is considered.
@@yerbba I appreciate that you answered my question. I’ve had surgery, radiation and I’m on anastrozole. 1 lymph node positive and clean margins. Oncotype was 14. Before this I thought I had 20-30 more years but now I take one day at a time!
My pathology report noted both extranodal extension and lymphovascular invasion (Stage 3, 11 positive nodes because the original tumor was actually under my arm, not on the breast) Because of this location I just assume I have a high risk of recurrence. Would I be able to stay on a targeted therapy long-term??
So informative! Thank you for such thorough and thoughtful information
We’re so glad you found the information informative and thorough!
@yerbba Thank you so much for this video . I do watch regularly your videos and they give a lot of information as well as they do give positive vibes for questions in mind and hope .
We're so happy to hear that our videos have been helpful for you during this time. Thank you for watching!
Thank you, Dr Griggs, for medical advice.
Thank you for watching and we appreciate you!
Your videos are incredibly helpful, thank you! It would be nice if you could teach us what to expect when we stop letrozole after 10 years of treatment. Will I feel better, and if so how?
This is a great question. One would expect that any side effects from the medication will resolve and go away after a couple of weeks to a couple of months. Most people find the hot flashes and similar side effects get better first.
Thank you very much for your information and for your kind way of informing us.
Thank you for the positive feedback. We appreciate your support.
Very informative, as always! Thank you!
Thank you for watching and the positive feedback! We appreciate the support.
Excellent video 🙌
Thank you for the positive feedback. We appreciate your support!
Such great informative video, thank you dr Griggs x
Thank you for watching. We appreciate your positive feedback and support!
Thank you Dr Jen for sharing..❤❤❤
Thank you so much for watching! We appreciate your support.
Thank for another informative video. A couple of questions - if a sentinel node biopsy is negative following chemotherapy and the surgery does that indicate recurrence is unlikely. Secondly I was injected with radioactive blue material injected directly into my breast prior to surgery. I understood that was to help the surgeon find the lymph nodes. I’d like to understand more about that as I took from your video that it is the pathologist who finds them. Thanks
We'll start with your second question first. The surgeon identifies the node or nodes that take up the blue dye or, in some people, the radioisotope, by looking at the lymph node with the naked eye. The pathologist is the one that identifies the actual nodal tissue and whether or not the lymph node(s) is or are positive under the microscope. Sometimes the lymph node may be enlarged or hard, both of which may indicate that the lymph node is likely to have cancer. For your second question, a negative lymph node after chemotherapy is a good sign, but the amount of tumor in the breast is also important in helping estimate a prognosis.
So helpful! Thank you!! I wonder though if vigorous exercise forces cancer in lymph nodes to spread more quickly? It seems like it would get things flowing through the lymphatic and blood stream more readily.
Any cells in the lymph nodes are well embedded in the tissues. As far as we know, vigorous exercise does not dislodge cancer cells from the lymph nodes.
Thank you for this video. Good information as always.
We appreciate your positive feedback. Thank you for watching and being part of the Yerbba community!
Thank you so much ... this answered my question about lymph nodes.
We are so glad you found this video helpful. Thank you for watching!
Great video, thank you for this! I had lumpectomy for my Er+ BC, stage 1a, with two sentinel lymph nodes taken out and pathology found no cancer cells in them. However, I would like to know,if no cancer cells were found in those two sentinel nodes, is there a possibility that in axillary lymph nodes ( if they were taken out but they did not) there would be some cancer cells? From your video I understood that they can pass some lymph nodes and go in others?
Good question. It is unlikely that someone with negative sentinel lymph nodes would have other lymph nodes that are positive. In someone with clinically negative lymph nodes (non-palpable, no enlargement or other abnormality on imaging studies), the likelihood that this would happen is very low.
Had sentinel lymph node biopsy with lumpectomy, all imaging prior showed benign nodes. Now dealing with cording and lymphedema, I'll have to live with a swollen arm and hand the rest of my life with constant physiotherapy appointments.
So hard to have such long term effects. Physiotherapy can be highly effective in helping with the types of problems you're having.
Have you gone on line and check out the message therapies to do and the Ti chi versions this im told is the only hope with lymphedema....
I have a problem as well, but it's weird sensations and extremely weak, and I was very strong, now 2 pounds feels like 30pds.
Good luck , and praying helps .
excellent video. Very informative! I'm curious about positive supraclavicular nodes. I have one positve. The few statistics that I can find are quite grim. Do you talk more in depth about these specific nodes and the role they play in any of your other videos? Thank you!!
Great question. Supraclavicular lymph nodes used to be classified as Stage IV disease. Then it was found that many people were being cured with systemic therapy and radiation therapy. This led to supraclavicular lymph nodes being reclassified as N3 and the overall stage as IIIc (3C). Yes, this is a serious illness but not without hope of cure.
Thankyou Dr.. very good information 💖🙏
Thank you for watching! We appreciate your support.
Does breast cancer spread through circulation or lymphatic system more? I have seen studies debating on this saying that the LNs filter, not spread cancer and that lymph nodes don't metastasize and rather that it comes though the blood system more. Would love to hear an education program on this topic.
It is thought that the circulatory system is more often the route of spread.
Why this difference from 3 to 4 lymph nodes? Why is 3 low risk ans 4 very high risk? It does make sense!
It is interesting, isn't it? Studies have shown that 4 or more nodes does make a real difference in terms of prognosis. But of course, the fewer the better. Thank you for watching.
I wish you were my doctor in the beginning.
Thank you for watching. We hope our videos are helpful!
Thanks 😊😊
Thank you for watching!
Thank you so very much 🙏
Thank you for watching! We appreciate your support.
Very helpful thank you!
Thank you for watching. We are so glad you found this video helpful!
Hi Dr.I had stage 2b breast cancer 30.5 years ago.One lymph node had a small amount of cancer in one node.I had a lumpectomy,chemo,and radiation.In March of 2020 i was diagnosed with stage 3 breast cancer.Advanced,after having a no evidence of disease letter sent 3 months before this! Cancer is sneaky!
Hi deborah and Dr. Riggs, if deborah had a mastectomy instead of a lumpectomy, do you think she could’ve been cancer free?
How are you now deborah? I’m also diagnosed with invasive ductal stage 1 grade 2. After Mri was called in, I found out that 2 of my lymph nodes are enlarged. Do I need to be concerned that my cancer has spread in my lymph nodes?
I actually had a lumpectomy first,2.0 centimeter in late 93.With one to several lymph nodes involved you should be o.k.,with proper treatment.Mine recurred in the axillary area,and skin which is a more serious condition.
Thank you for opening up about your incredible journey. Facing stage 2b breast cancer and now navigating through a stage 3 diagnosis after a period of no evidence of disease must have its own challenges. We're here alongside you, and if there's anything more specific you'd like to learn about, please let us know.
@yerbba Dr.Griggs thank you for all that you do to help us understand breast cancer.After having 18 lymph nodes removed,and only a small amount in one 30.5 yrs.ago.I thought I wouldn't ever have a concern in my axilla area.So 4 yrs.ago the cancer recurred as a 1.5 cm.tumor,with an inch of skin involvement.What a surprise since it was not in my lymph nodes.Anyway,I did have radiation with 10 boost extra,because of not having clear margins in Nov.93.Thank you again for helping everyone on here.
I'm surprised she didnt reveal the real deal with nodes being removed that's a huge problem and the oncologist needs to tell their patients the truth.
We're not quite sure what you mean and we agree that doctors need to be honest with their patients. Some patients do not want the "whole truth," so it's important for doctors to ask what type of information the patient wants.
Hi Dr, thanks for this video. I currently have stage 2 with a 4.5 CM tumor with 1 positive lymph node. I am 40 years old. My doctor says that because of my age they recommend Chemo regardless of my oncotype score. I was wondering your opinion on that? I’ve done a lot of research and I haven’t found anybody mentioning that being young (40 years old) is a definite benefit to chemo regardless of Oncotype until my doctor mentioned it. My cancer is Hormone positive and Her 2 negative. Would love to hear your thoughts on my age as a deciding factor for deciding on chemo? Thank you!
Age plays a role in chemotherapy decisions once an OncotypeDX score is back. For people who are younger, a lower score will often lead to a recommendation for chemotherapy. But without an OncotypeDX score, you are right, age no longer plays an independent role in chemotherapy recommendations.
Hi Doc,also kindly explain the link of sciatica and cancer patients
Thanks for the question. There is no relationship between sciatica and cancer unless someone has recurrent cancer that compresses the sciatic nerve. This is extremely uncommon.
Is the pathologist working in the same surgery room together with the surgeon while we are having the surgery meaning that the surgeon is receiving the information so he/she knows how to proceed with the lymph nodes? I know it’s a long question but I am very curious about it. Thank you!!
The pathologist is rarely in the operating room with the surgeon. Space limitations and concerns about maintaining a sterile environment make it difficult to add in another person with the required equipment. In places where the pathologist and operating room are near one another, the sharing of information is seamless and prompt.
Tha k you so much, I wish I had this information in 2020 from my surgeon and oncologist .
Informative, but , I have more questions ...
Good luck to everyone with any type of diseases😎🙏
Thank you for your kind words! It's never too late to seek answers, so please feel free to ask your questions.
🌎🩺💖🙏 Thanks Dr. Jen
Thank you for watching!
When you have metastatic disease. Internal mammary chain adenopathy noted . Does that mean there are cancer cells present in the lymph node?
Great question. This finding on imaging may mean that there are cancer cells in these lymph nodes. In general, the treatment given for the other sites in the body will treat these lymph nodes as well.
Thanks Doc.
Dr. Hussain
Thank you for watching!
Thanks for the info . Do I have to worry about lymph nodes at the end of my jaw line ? It developed during my chemo sessions . Also my sentinal lymph node is clear .
It would be worth showing your doctor the lymph node that you're noticing. This is not a typical place where lymph nodes show up related to breast cancer, but it never hurts to check.
Thank you Doctor.
May i ask, would you mind telling us more about how lymph nodes work and how cancer cells go about reprogramming the nodes over time to see the cancer as "friendly"?
I just had an 80 x 50 x 60 mm tumour removed from my breast, with one node having a macro-metastasis of >10mm (but no extrusion escaping through the node wall).
At what point do cancer cells reprogramme the lymphatic system to see cancer as "friend" and therefore no longer send cells to attack the tumour?
When one node has been reprogrammed, and lets tge cancer basically claim squatters rights, live in there, and reproduce in the node: does that mean the whoke lymphatics system has come to see that particular cancer as "friendly" and so won't attack it in future?
Is this how lobular carcinoma manages to lay down micro-metastases early, and our bodies reach a point where our TNFactor and the various immune cells then won't attack those micrometastases?
Good questions, and there is of course a lot of interest in these questions. It's important to differentiate between the lymph nodes and the immune system. The lymphatic system is only part of the immune system. Immune cells are present throughout the body, including the blood and the tissues themselves.
I've got a sudden appearance of a lump in my right breast which can be seen as rather a large lump on digital photos I took..I've had painful lymph nodes under my right armpit for around 1 month..severe Shingles I got early September and I'm extremely tired with a red rash over the right breast plus in between which doesn't go away..Im 52 and it is also painful on my right side near the armpit..Im going back to the doctors in a day..Any thoughts?please..😐😒
Thanks for writing. Without being part of your medical team and having the ability to examine you, it is difficult to render an opinion. The best guidance we can give is to see your doctor soon.
Day 1 post surgery
Thank you for sharing. It's important to give yourself grace during this time and focus on your healing. Make sure to follow your healthcare team's advice closely, stay hydrated, and rest as much as possible. Wishing you a smooth and gentle recovery.
3c tnbc… so tough to accept
Facing a diagnosis of stage 3C triple-negative breast cancer (TNBC) is undeniably a significant challenge. It's completely normal to feel a range of emotions, including difficulty in acceptance. Remember, you're not alone in this. There is a community of support here for you. Thank you for watching.
@@yerbba Thank you for what you do and the positive spirit you have.
Hello, I had many nodes removed from my left arm and armpit (due to cancer), and thought the few healthy nodes would duplicate. I asked my Oncologist if they woud and was told no !
You mention recruiting lymphoid tissue - how can/does this happen please? Thank you.
Our bodies are amazing, and it's not uncommon for people who have a second lymph node dissection after a complete dissection in the past to have lymph nodes that were not there previously.
How much should the patient or would want to know? Since you talk about lymph nodes why not tell about LVI.
Are some cancers of stem cell origin? If so what kills them?
Does IHC predict prognosis? If yes, why do favorable IHC outcomes die?
What is DCIS? If it’s not a ‘cancer’, why do pure DCIS patients die?
You are asking great questions, and we can sense the emotion behind your questions. Angiolymphatic invasion, also called lymphovascular invasion or LVI, is not related to lymph node status. You may want to check out our video about angiolymphatic invasion here: ua-cam.com/video/VvNRJc7jN6o/v-deo.html
There is important work about cancer stem cells and treatments directed against cancer stem cells. For our other viewers, cancer stem cells are a distinct subpopulation within tumors that exhibit stem cell-like properties and are believed to play a crucial role in tumor initiation, progression, and resistance to conventional therapies. It is not possible to determine which cells are stem cells from a tumor. Antibody-drug conjugates and other therapies are offering great promise.
Some people with so-called favorable breast cancer can indeed have a recurrence and eventually die from their cancer. You may find our video on why we haven't cured cancer to be helpful: ua-cam.com/video/fLcq25CvtcM/v-deo.html
People with pure DCIS who die of breast cancer most likely had invasive cancer that was not detected in the tumor specimen. This is exceedingly rare.
Hello doctor actually im new in canada and im having swolen lymph nodes and i don't know what is this and how can i be treated and is this a stage of breast cancer and i also have pain in my right side of body
Thanks for writing. Without being part of your medical team, it is difficult to know if these lymph nodes are related to cancer and what is causing your pain. If possible, seeing your primary care doctor is likely to be the next best step. If you have a known diagnosis of cancer, your cancer team can also help.
I had 1+ lymph node with favorable tumor grades and did not receive chemo or radiation and 2yrs later I have a regional reoccurrence. I don’t understand
This does sound confusing. We hope you can ask your team about the decision-making process. Thank you for watching!
1/3 is really scaring , are positive lymphe nodes that are still in the capsule more favorable in terms of prognosis?
People with cells that have not broken through the capsule may have a lower risk of locoregional recurrence.
Hello Dr. Griggs, as usual what an excellent informative video.
ER/PR+ HER2-, stage 3, single mastectomy, with no lymph nodes involved but surgeon removed a few from my armpit and then other ones were treated with radiation in my collarbone (one year and two months ago). After months of recovery I started having lymphedema in my chest and armpit (swollen and painful), I have been attending lymphedema therapy for more than 6 months already, question is will it ever go away or how does it work? I know each case is different but just to have an idea.
A lymphedema video would be helpful too, unless you had already done it and I don’t know? Thank you ❤
Thank you for your kind words. Lymphedema can be challenging, and while it often improves with therapy, it might not completely go away. We have a few lymphedema videos that may offer more insights-you can watch them here! [ua-cam.com/video/rwy00ae40_E/v-deo.html] [ua-cam.com/video/INkM2ZFsNE0/v-deo.html]
How long can someone take for their body to heal from chemotherapy ?
The side effects last for a variable amount of time. You may find our video on the duration of chemotherapy side effects helpful. If you have other questions, come back and let us know. ua-cam.com/video/smdh7F_WNYA/v-deo.html
Can you have ctdna if your lymph nodes were clear?
The role of ctDNA is not entirely clear regardless of the stage of disease. There are no studies showing that outcomes are improved in people who have ctDNA testing done.
I finished breast cancer treatment for six months now but i feel some lumps above my right collar bone....is it recurrence...i am taking tamoxifen now
Thank you for writing. We cannot provide medical advice without being part of your care team and would encourage you to talk with your medical team.
My friend got an ultrasound today and they found breast cyst, lymph node and mass can that be cancer?
We understand this must be a concerning time for your friend. It's important to note that while these findings could be related to various conditions, including non-cancerous ones, it's crucial for them to consult with a healthcare professional for a thorough assessment. Encourage your friend to share their concerns and feelings with their medical team, who can provide the necessary guidance and support during this process.
Are you staging by the AJCC 2018, because I was staged at 2B, under the AJCC 2018 I was 1A
Yes, we are using the AJCC 2018 staging system.
It didn’t seem that you were by stating the size of the tumour and nodes, the 8th edition came out January 2018, there will not be a 9th edition however a 9th version digitally, there’s an app called Oncoassist
I was diagnosed with TNBC, after I fell from stairs and hit my right breast. I bruised and an abcess occured and created a tumor according to my doctor. I never and still don't have any breast cancer or under armpit lymph node symptoms. I was tender, bruised and swollen under my right breast after the fall. Now my doctor wants to do a masectomy diagnosing me with stage 3 TNBC, my underarmpits are not swollen anymore, but he wants to remove all my lymph nodes when I never had any pain or symptoms. Is this normal? I don't want to have lymphadema or any other life threatening illnesses due to a fall.
This sounds really rough. The fall did not cause the cancer, but it certainly got the attention of the doctors! Lymph nodes are examined under the microscope even if there are no symptoms to decrease the risk of recurrence and to help determine the specific treatment plan.
Hi doc i have lymph nodes 1 out of eleven positive for tumor
Thank you for sharing. Stay in close communication with your doctor to understand the next steps and available treatments.
Is it not normal to have benign size lymp nodes? That can be detected in your axillary regions? Does it mean you have cancer?
Enlarged lymph nodes can occur for various reasons, and they aren't always a sign of cancer. To learn more, we invite you to watch our video that explores how not all lumps are cancerous: ua-cam.com/video/3TxPRY-CXjY/v-deo.html In very thin people, the lymph nodes can be felt even when benign. Nonetheless, enlarged lymph nodes should be evaluated by a clinician.
I have lymphedema in my right arm due a lot bodes being removed along with my breast . If the lump bodes brow back will my arms swelling go away ? Thank you
In people having lymphedema, prompt management of the lymphedema is needed to decrease the risk of it getting worse.
What are hardened lymph nodes. I've breast cancer and a hardened 19mm lymph node under my arm. What causes that please
Hardened lymph nodes can be a sign that your immune system is responding to something, such as an infection. It’s important to have this checked by your oncologist to determine the exact cause.
Their going to do another biopsy. But thankyou anyway
My mother recently diagnosed with this, CT scan showing that the tumer not affected any other part of the body, but lymh nodes are affected, due to which, her right arm swell, first cemo session has been done, how long it will take to lymph fluid become normal, and the selling will be reduced?
The swelling is likely related to the surgery. It is important to get treatment for any arm or chest swelling as soon as possible to avoid having such swelling become longstanding. You may want to check out our video on lymphedema here: ua-cam.com/video/rwy00ae40_E/v-deo.html
@@yerbba Thanks for the reply. In the video you mentioned that Lymphedema happened due to after breast cancer treatment / surgery. But in my mothers case, her right arm swell before she diagnosed cancer. We consult with multiple doctors including orthopaedic doctors for the arm issue, and luckily one doctor said this is something else. I can share her biopsy report in personal if needed.
Confused. I have stage 1, level 1. Lumptectomy in 2 weeks when one node will be removed and tested. But if the slow growing tumor has not spread to nodes is radiation needed? Are you saying it can return elsewhere even if prognosis is good?
Radiation therapy is actually given to decrease the risk of recurrence in the breast and neighboring (regional) lymph nodes. Radiation therapy in your case does not decrease the risk of cancer returning in other parts of the body. Even if the surgical margins are clear, radiation therapy decreases the risk of the cancer coming back in the breast after surgery.
@@yerbbathis confuses me. Radiation doesn’t decrease the risk of it reoccurring elsewhere and yet it dii or es decrease the risk of it returning in the same spot. Yet mine is slightly w growing and doc says I have 10!years risk free. At 78 dies radiation make sense? ?
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