lymphedema

I had a biopsy a few weeks ago and it came back positive for breast cancer.  My oncologist assures me it is early stage but the lymph nodes still need to be biopsied in surgery.  I am frightened more about that if it has gone to the lymph nodes than I am the cancer.  I have heard horror stories about dealing with lymphedema.  Is it really that bad?  Do you have to wear that sleeve all the time or just on occasion?  All of my reports have come back very good.  I am Stage 1 right now, but I also have a calcification area in the same breast that has to be biopsied.  My PET scan came back showing no problems except for the one lump, but didn't mention the calcification area.  I forgot to ask my oncologist why it didn't mention that because we know it's there from the mammogram and ultrasound.  Why wouldn't they have mentioned it from the PET scan?  One more question, it there is a problem in the lymph nodes would it have shown on the PET scan?

[Cleveland Clinic]

Dear carol05:  It is routine to sample a few lymph nodes whenever a positive cancer is found in the breast.  Although less likely in small tumors, it is still positive to have metastasis to a lymph node.  Microscopic lymph nodes may or may not show up in a PET scan.  Having said this, the usual practice in most settings is to do a sentinel lymph node biopsy and remove only a small sample (3-6 most of the time) of nodes.  This small of a sample would not be likely to cause lymphedema.  Most lymphedema occurs when either there are large numbers of lymph nodes removed or the lymph nodes are radiated (due to involvement of cancer).  Though lymphedema can still occur, it is with far less frequency than in the old days when we removed large numbers of lymph nodes.  PET scans show areas of hypermetabolic activity (cells that are active).  Calcifications are not cancer but they sometimes form around cancers.  Calcifications are not metabolically active and therefore, would not show on a PET scan.