I don't want to lose all my lymph nodes!

I was diagnosed in February with  6.0 centimeter invasive ductal carcinoma in my right breast.  I am Estrogen + Progesterone - Her2 -  I am not sure what the stage is--the grade is 3.  My oncologist recommended chemo first--4 rounds of FEC, and 4 of Taxol.  I have completed those.  They didn't biopsy my sentinel node, but it was swollen in the MRI and looked involved as well.
  Now my surgeon will do a lumpectomy, and remove all lymph nodes under my right arm.  
  Is this something I need to get a second opinion on?  I thought she would biopsy each node before she removed it--I am concerned about losing range of motion, and lymphedema--etc.  Please advise--

[katarina777]

They never biopsy every single node. What they do these days is biopsy the first node, or maybe up to the first three nodes the cancer would have most likely spread to, and depending on this result, and other factors as well, they either remove all, or some, or no nodes at all.

I suspect that in your case it is the swelling that makes your doctor want to be safe.

It is also not really true as once believed that when you only have one node removed, or a few dissected vs. all of them removed, that the risk of developing lymphedema is higher in proportion how many nodes were cleared out.

I think one of the more important things one can do is do Physical Therapy after surgery, and/or a lot to help prevent problems. Of course the surgeon's expertise/experience,  and your individual make up, are also factors.

What I am trying to say is that it's not all clear cut.

My PT (Physical Therapist told me that the worst case of lymphedema she has seen was in a woman who had only one node removed.)

Another factor has to do with the experience of the surgeon in habing done many, many sentinal node biopsies and knows what he/she is doing.

If it was me, I would rather have them all taken out then only a couple by an inexperienced surgeon, and which can backfire.

I personally had all lymphnodes removed as this was nesessary and although I had problems of various sorts with my right arm, these troubles have long resolved themselves and are no longer an issue.

Hope this helps a little, KAT

[katarina777]

PS: They do often biopsy all the nodes but not until the major surgery is done? I am not 100% sure about this. Kat

[Paulatkc]

Thank you so much for your answer--it reassured me and helped me to feel more peaceful!  I have my surgery this Friday, and thanks to you, I have more confidence and am able to resume the peace that I have felt up to now--bless you and thank you!

[katarina777]

Thank you also so much for writing back. Most people who ask questions on this 3/4 forum never respond to the person who answered, even when much care was put into the response. So, thanks Paulatkc, as this made a big difference to my day. KAT

You'll be OK, and write back if you need to/want to after your surgery?

[Kemal]

Hi,

My suggestion is that you do whatever you can to find out if you are stage 3 or 4.  You might want to insist on having a full contrasting CT Scan.

Kemal

[Paulatkc]

Thanks for responding Kemal.  I had my lumpectomy on the 6th of Aut--my surgeon removed 20 lymph nodes--awaiting pathology now--The recovery has been a little rough--drain tube is annoying, but pain pills work well--thanks for your suggestion for a CT scan--