Aa
Intramammary Node vs. Sentinel Node, course of therapy and prognosis
My mom had a mastectomy on her Right breast last week and I am a bit confused by the findings. It was a 1cm mass, grade 3 tumor and they took 16 lymph nodes for dissection. The sentinel node and all but 1 lymph node came back with no cancer cells. There was an intramammary lymph node in the general location of the tumor that came back showing some cancer cells. I am trying to figure out what this means in terms of her treatment that will be needed (ie: chemo regimen) and her overall prognosis (ie: are folks able to survive this and live for a long time afterwards? how long?). While I know that biopsies aren't supposed to spread cancer cells, her biopsy caused a very large hematoma which lasted for 10 days until the mastectormy. I am hoping that (maybe) the intramammary node was positive for cancer because it picked up cells from the hematoma as a result of the biopsy and that the mastectomy effectively got rid of all cancer. (her bone scan and CT scan came back clean). My questions are:
1.) how do you interpret the finding of the lymph node situation as described above? (ie: i know there is about 5% false negative for sentinel node and about 20% incidence of a postive intramammary node)
2.) what chemo regimen will they likely prescribe (length and type?)
3.) how hopeful can our family be at this point that mom will be around for the next 5, 10, 15 ,20 years to see the grandkids grow up?
Sorry for all the questions, but as you can see, I have been Googling like crazy for the last 2 weeks and not sleeping much. Thanks and God Bless. This is a great website.
1.) how do you interpret the finding of the lymph node situation as described above? (ie: i know there is about 5% false negative for sentinel node and about 20% incidence of a postive intramammary node)
2.) what chemo regimen will they likely prescribe (length and type?)
3.) how hopeful can our family be at this point that mom will be around for the next 5, 10, 15 ,20 years to see the grandkids grow up?
Sorry for all the questions, but as you can see, I have been Googling like crazy for the last 2 weeks and not sleeping much. Thanks and God Bless. This is a great website.
I thought I would post about some of the questions I saw here.
For maa and the numbness, my surgeon told me it will never go away and my husband agrees. In a mastectomy, the nerves to the skin of the breast are severed and they don't usually rejuvenate. It's an odd feeling to get used to, but probably far better than it being painful. Plus, with the node dissection, the underside of my left arm is numb down about midway, then feeling picks up again. She (surgeon) said this feeling might come back, but everyone is different. I have no sign of any lymphedema, which is great, but I have been religious about doing my wall-climbing up above the head exercises. I do have full range of motion in both arms.
As far as activity, I was very active before surgery, and have tried to stay that way. If I can't run on a day, I try to walk at least 5 miles, and if that is not possible, I try to spend 45 minutes on the elliptical at the Y. I am determined not to lose muscle as I lose weight. I can't stand flat butt syndrome, though it would go along with my flat chest syndrome. Before surgery, I used to just shower in the group showers at the Y. Have not been brave enough to do that after the surgery, but I wish I was. Just think, there might be someone else who is getting ready to have a mastectomy and they could ask me what it was like etc.... Have never seen anyone post-mastectomy in the group shower. We are all a bunch of wimps.... I guess. Give me some courage guys.
I am hoping to be back running half marathons next fall. That is what I love, running in the spring and fall, when the seasons change.... pushing myself. Cute little sports bras with my new B breasts pointed straight forward.... hah.
Lets see, what else. I can't really comment about the energy level. I comes and goes, but then I have the chemo too. I did not really have any time, maybe a 10 days between surgery and the chemo starting, so hard to really judge my recovery from the mastectomi. Once the drains were out, it seemed not so bad. The drains were the yucky part. I am lucky to have my husband, who totally took care of the drains, all the emptying and stripping and he even pulled 2 of them for me. So I'm not the best model for that. I'm lucky to have a doc for a husband period.... he is my sounding board for everything.
As far as the depression, I have considered an antidepressant, but I don't think I need one. I am a psychiatric nurse for 20 years, and I think at times I have a situational depression, but once I'm through with the treatment, I think I will be fine. I talk with my psychiatrist friends, who are only too happy to jump in with some lexapro when I need some, but I'm trying not to do that. I've never been a depressed type person, and I think my reactions and feelings are probably pretty normal. I do take ativan (benzodiazipine family) during the day, it helps me to eat. And I take 5 mg of ambien to sleep at night. On chemo weeks, I take a bit more ativan and compazine, just because I have this overwhelming nausea, and I know I need to eat. I also have a bad case of pre-chemo (anticipatory) nausea, so on the day before chemo and in the morning of chemo, I take a lot of anti-anxiety stuff, (including 10 mg of valium) just to be able to show up at the infusion room. But, that's just me and my strange brain. I've always been like that. Still can't eat jello or anything jiggly, just because when I was 10 years old, my mom gave me a big serving of jello when I was sick, I vomitted green jello for hours on end and still can't even look at the stuff.
Thats all for now. Hope this helps those to come.
Be well friends,
Tammie
For maa and the numbness, my surgeon told me it will never go away and my husband agrees. In a mastectomy, the nerves to the skin of the breast are severed and they don't usually rejuvenate. It's an odd feeling to get used to, but probably far better than it being painful. Plus, with the node dissection, the underside of my left arm is numb down about midway, then feeling picks up again. She (surgeon) said this feeling might come back, but everyone is different. I have no sign of any lymphedema, which is great, but I have been religious about doing my wall-climbing up above the head exercises. I do have full range of motion in both arms.
As far as activity, I was very active before surgery, and have tried to stay that way. If I can't run on a day, I try to walk at least 5 miles, and if that is not possible, I try to spend 45 minutes on the elliptical at the Y. I am determined not to lose muscle as I lose weight. I can't stand flat butt syndrome, though it would go along with my flat chest syndrome. Before surgery, I used to just shower in the group showers at the Y. Have not been brave enough to do that after the surgery, but I wish I was. Just think, there might be someone else who is getting ready to have a mastectomy and they could ask me what it was like etc.... Have never seen anyone post-mastectomy in the group shower. We are all a bunch of wimps.... I guess. Give me some courage guys.
I am hoping to be back running half marathons next fall. That is what I love, running in the spring and fall, when the seasons change.... pushing myself. Cute little sports bras with my new B breasts pointed straight forward.... hah.
Lets see, what else. I can't really comment about the energy level. I comes and goes, but then I have the chemo too. I did not really have any time, maybe a 10 days between surgery and the chemo starting, so hard to really judge my recovery from the mastectomi. Once the drains were out, it seemed not so bad. The drains were the yucky part. I am lucky to have my husband, who totally took care of the drains, all the emptying and stripping and he even pulled 2 of them for me. So I'm not the best model for that. I'm lucky to have a doc for a husband period.... he is my sounding board for everything.
As far as the depression, I have considered an antidepressant, but I don't think I need one. I am a psychiatric nurse for 20 years, and I think at times I have a situational depression, but once I'm through with the treatment, I think I will be fine. I talk with my psychiatrist friends, who are only too happy to jump in with some lexapro when I need some, but I'm trying not to do that. I've never been a depressed type person, and I think my reactions and feelings are probably pretty normal. I do take ativan (benzodiazipine family) during the day, it helps me to eat. And I take 5 mg of ambien to sleep at night. On chemo weeks, I take a bit more ativan and compazine, just because I have this overwhelming nausea, and I know I need to eat. I also have a bad case of pre-chemo (anticipatory) nausea, so on the day before chemo and in the morning of chemo, I take a lot of anti-anxiety stuff, (including 10 mg of valium) just to be able to show up at the infusion room. But, that's just me and my strange brain. I've always been like that. Still can't eat jello or anything jiggly, just because when I was 10 years old, my mom gave me a big serving of jello when I was sick, I vomitted green jello for hours on end and still can't even look at the stuff.
Thats all for now. Hope this helps those to come.
Be well friends,
Tammie
I thought I would post about some of the questions I saw here.
For maa and the numbness, my surgeon told me it will never go away and my husband agrees. In a mastectomy, the nerves to the skin of the breast are severed and they don't usually rejuvenate. It's an odd feeling to get used to, but probably far better than it being painful. Plus, with the node dissection, the underside of my left arm is numb down about midway, then feeling picks up again. She (surgeon) said this feeling might come back, but everyone is different. I have no sign of any lymphedema, which is great, but I have been religious about doing my wall-climbing up above the head exercises. I do have full range of motion in both arms.
As far as activity, I was very active before surgery, and have tried to stay that way. If I can't run on a day, I try to walk at least 5 miles, and if that is not possible, I try to spend 45 minutes on the elliptical at the Y. I am determined not to lose muscle as I lose weight. I can't stand flat butt syndrome, though it would go along with my flat chest syndrome. Before surgery, I used to just shower in the group showers at the Y. Have not been brave enough to do that after the surgery, but I wish I was. Just think, there might be someone else who is getting ready to have a mastectomy and they could ask me what it was like etc.... Have never seen anyone post-mastectomy in the group shower. We are all a bunch of wimps.... I guess. Give me some courage guys.
I am hoping to be back running half marathons next fall. That is what I love, running in the spring and fall, when the seasons change.... pushing myself. Cute little sports bras with my new B breasts pointed straight forward.... hah.
Lets see, what else. I can't really comment about the energy level. I comes and goes, but then I have the chemo too. I did not really have any time, maybe a 10 days between surgery and the chemo starting, so hard to really judge my recovery from the mastectomi. Once the drains were out, it seemed not so bad. The drains were the yucky part. I am lucky to have my husband, who totally took care of the drains, all the emptying and stripping and he even pulled 2 of them for me. So I'm not the best model for that. I'm lucky to have a doc for a husband period.... he is my sounding board for everything.
As far as the depression, I have considered an antidepressant, but I don't think I need one. I am a psychiatric nurse for 20 years, and I think at times I have a situational depression, but once I'm through with the treatment, I think I will be fine. I talk with my psychiatrist friends, who are only too happy to jump in with some lexapro when I need some, but I'm trying not to do that. I've never been a depressed type person, and I think my reactions and feelings are probably pretty normal. I do take ativan (benzodiazipine family) during the day, it helps me to eat. And I take 5 mg of ambien to sleep at night. On chemo weeks, I take a bit more ativan and compazine, just because I have this overwhelming nausea, and I know I need to eat. I also have a bad case of pre-chemo (anticipatory) nausea, so on the day before chemo and in the morning of chemo, I take a lot of anti-anxiety stuff, (including 10 mg of valium) just to be able to show up at the infusion room. But, that's just me and my strange brain. I've always been like that. Still can't eat jello or anything jiggly, just because when I was 10 years old, my mom gave me a big serving of jello when I was sick, I vomitted green jello for hours on end and still can't even look at the stuff.
Thats all for now. Hope this helps those to come.
Be well friends,
Tammie
For maa and the numbness, my surgeon told me it will never go away and my husband agrees. In a mastectomy, the nerves to the skin of the breast are severed and they don't usually rejuvenate. It's an odd feeling to get used to, but probably far better than it being painful. Plus, with the node dissection, the underside of my left arm is numb down about midway, then feeling picks up again. She (surgeon) said this feeling might come back, but everyone is different. I have no sign of any lymphedema, which is great, but I have been religious about doing my wall-climbing up above the head exercises. I do have full range of motion in both arms.
As far as activity, I was very active before surgery, and have tried to stay that way. If I can't run on a day, I try to walk at least 5 miles, and if that is not possible, I try to spend 45 minutes on the elliptical at the Y. I am determined not to lose muscle as I lose weight. I can't stand flat butt syndrome, though it would go along with my flat chest syndrome. Before surgery, I used to just shower in the group showers at the Y. Have not been brave enough to do that after the surgery, but I wish I was. Just think, there might be someone else who is getting ready to have a mastectomy and they could ask me what it was like etc.... Have never seen anyone post-mastectomy in the group shower. We are all a bunch of wimps.... I guess. Give me some courage guys.
I am hoping to be back running half marathons next fall. That is what I love, running in the spring and fall, when the seasons change.... pushing myself. Cute little sports bras with my new B breasts pointed straight forward.... hah.
Lets see, what else. I can't really comment about the energy level. I comes and goes, but then I have the chemo too. I did not really have any time, maybe a 10 days between surgery and the chemo starting, so hard to really judge my recovery from the mastectomi. Once the drains were out, it seemed not so bad. The drains were the yucky part. I am lucky to have my husband, who totally took care of the drains, all the emptying and stripping and he even pulled 2 of them for me. So I'm not the best model for that. I'm lucky to have a doc for a husband period.... he is my sounding board for everything.
As far as the depression, I have considered an antidepressant, but I don't think I need one. I am a psychiatric nurse for 20 years, and I think at times I have a situational depression, but once I'm through with the treatment, I think I will be fine. I talk with my psychiatrist friends, who are only too happy to jump in with some lexapro when I need some, but I'm trying not to do that. I've never been a depressed type person, and I think my reactions and feelings are probably pretty normal. I do take ativan (benzodiazipine family) during the day, it helps me to eat. And I take 5 mg of ambien to sleep at night. On chemo weeks, I take a bit more ativan and compazine, just because I have this overwhelming nausea, and I know I need to eat. I also have a bad case of pre-chemo (anticipatory) nausea, so on the day before chemo and in the morning of chemo, I take a lot of anti-anxiety stuff, (including 10 mg of valium) just to be able to show up at the infusion room. But, that's just me and my strange brain. I've always been like that. Still can't eat jello or anything jiggly, just because when I was 10 years old, my mom gave me a big serving of jello when I was sick, I vomitted green jello for hours on end and still can't even look at the stuff.
Thats all for now. Hope this helps those to come.
Be well friends,
Tammie
Thank you carme, I really forget to do that sometimes thats why I read the kind of books I do to remind me. I am making a committment to relaxing more and it isnt easy but if I keep it at the fore front of my head (and thats crammed already too with other stuff), I may have a chance of controlling it better.
maa I am 5 weeks post op today. I think with a masectomy its 6-8 weeks recovery time before going back to work. I am just being a wimp with my lumpectomy. Somebody at work said dont come back till you are ready because you know how they are. Good advice!!! I had like 138 or so hours of sick leave and close to that vacation since I hardly ever took one. Maybe that was one of my problems too. Im going to hate to look at my totals when I get back but if I need time off, I will take it anyway. Especially if I start feeling tired from the radiation treatments which can happen mid span. I will just have the Dr write a note to keep me out for 2-3 days as needed. Where I use to work they were more understanding when my friend went through it. She'd call and say that she just couldnt make it in because she felt so tired and needed to rest, and they worked with her. I dont feel I have that where I am.
I drove to Julian finally yesterday. I could see where the fires were and in some places before getting their, I could smell the soot and singey after effects. Not nearly as bad of course as when they were blazing. I took you all with me in my heart. Where I had breakfast, in the restroom they had a lpretty teacup painted with flowers and under it was scripture. I memorized it yesterday: Trust in the Lord and do good . It was a Psalms verse I believe. I bought a pair of earrings and something called a cell phone lanyard that has pretty beads on it. Took me about an hour to figure out how to put it on the phone last night but I found a website-FINALLY!!! That had directions. Bought some honey from up there, elderberry jelly, and apple butter. ALl are homemade from up there. Stopped off at an egg ranch and bought a dozen of fresh eggs then came home.
It takes about an hour and 20 minutes each way to there. Got there at 9:20, and got back at 12:40 because I had my cat scan to go to. Didnt walk yesterday, was pooped!!
The scan itself wasnt all that bad but I had to put my hands on the handle bars again. The tech noticed I reacted a little to the tattoos. They were just a little red and raised a little around the dye. He said to use neosporin for a couple of days and that should take care of it. Already looks like the redness is gone but one more day cant hurt.
When you feel you are ready to walk, go for it cause your body is telling you something. Im going to inspect the Y today after seeing a friend at my own work. That would be so nice to buddy up and go to the gym, I agree.
Better get ready. Im actually going to put on makeup. That will take FOREVER.
maa I am 5 weeks post op today. I think with a masectomy its 6-8 weeks recovery time before going back to work. I am just being a wimp with my lumpectomy. Somebody at work said dont come back till you are ready because you know how they are. Good advice!!! I had like 138 or so hours of sick leave and close to that vacation since I hardly ever took one. Maybe that was one of my problems too. Im going to hate to look at my totals when I get back but if I need time off, I will take it anyway. Especially if I start feeling tired from the radiation treatments which can happen mid span. I will just have the Dr write a note to keep me out for 2-3 days as needed. Where I use to work they were more understanding when my friend went through it. She'd call and say that she just couldnt make it in because she felt so tired and needed to rest, and they worked with her. I dont feel I have that where I am.
I drove to Julian finally yesterday. I could see where the fires were and in some places before getting their, I could smell the soot and singey after effects. Not nearly as bad of course as when they were blazing. I took you all with me in my heart. Where I had breakfast, in the restroom they had a lpretty teacup painted with flowers and under it was scripture. I memorized it yesterday: Trust in the Lord and do good . It was a Psalms verse I believe. I bought a pair of earrings and something called a cell phone lanyard that has pretty beads on it. Took me about an hour to figure out how to put it on the phone last night but I found a website-FINALLY!!! That had directions. Bought some honey from up there, elderberry jelly, and apple butter. ALl are homemade from up there. Stopped off at an egg ranch and bought a dozen of fresh eggs then came home.
It takes about an hour and 20 minutes each way to there. Got there at 9:20, and got back at 12:40 because I had my cat scan to go to. Didnt walk yesterday, was pooped!!
The scan itself wasnt all that bad but I had to put my hands on the handle bars again. The tech noticed I reacted a little to the tattoos. They were just a little red and raised a little around the dye. He said to use neosporin for a couple of days and that should take care of it. Already looks like the redness is gone but one more day cant hurt.
When you feel you are ready to walk, go for it cause your body is telling you something. Im going to inspect the Y today after seeing a friend at my own work. That would be so nice to buddy up and go to the gym, I agree.
Better get ready. Im actually going to put on makeup. That will take FOREVER.
doing fine. Still waiting on results. Surprise surprise. It does seem like we wait a lot. Hurry up then wait. I was busy on Monday, then drove and took my little guy to preschool, ran errands, went to see my son get his varsity letter at an evening program. Wed. got up around 9:00 then fell asleep again and didn't wake up til 1 in the afternoon. I never do that Wow. I was pooped. I guess I did to much mon and tues. How many weeks do they give you off for a mastectomy? I am into my 4th week of healing. Tuesday was the first day i drove - i have manual transmission. Still have pain with my implant. My sister-in-law talk to someone who just got implants and they too had pain under the arm. So I'm am glad it is the implant and not the mastectomy. She is just fine now no pain.
Labhusky - couldn't imagine lifting my arm over my head. Due to the fact that I have an implant he didn't want me doing any exercises and I couldn't now even if I wanted to. So good for you. How many weeks out are you from surgery. I thought about walking also I think that would be good for me and I told my husband when this mess is over I am going to join a gym too. Shame we are not in the same neighborhood we could go together and motivate each other. Also does anyone know when the numbness in the breast wears off? Gradually I am getting feeling but was wondering is it a year for the whole thing or months or what.
Go to plastic surgeon tonight. Not sure what he is doing tonight - hopefully not more saline. But after a few days you get used to the stretch.
Take care all.
Labhusky - couldn't imagine lifting my arm over my head. Due to the fact that I have an implant he didn't want me doing any exercises and I couldn't now even if I wanted to. So good for you. How many weeks out are you from surgery. I thought about walking also I think that would be good for me and I told my husband when this mess is over I am going to join a gym too. Shame we are not in the same neighborhood we could go together and motivate each other. Also does anyone know when the numbness in the breast wears off? Gradually I am getting feeling but was wondering is it a year for the whole thing or months or what.
Go to plastic surgeon tonight. Not sure what he is doing tonight - hopefully not more saline. But after a few days you get used to the stretch.
Take care all.
God speed! You can do it...don't forget to breathe.
I went today to the rad oncologist. I signed the consent form for the rads, then the fun began. Had a nice talk with the Dr there. I had to ask him about the surgical margins. He said 10 was good and she got 14, so I feel better there.
I brought a little tube of "jeans cream" that I am planning on using and he said thats fine. Her website is jeanscream.com Its got aloe vera and vit E. I told him I wanted to join the Y on Friday and he said thats fine but to not go more than 3 days a week because of the possible fatigue. We talked about walking and Ive been doing it since the 1st and he said that will actually help with the fatigue. Nothing too strenous (sp.). He said dont take Vitamins A, C and E but that a mulit vitamin is fine. Once we get started, he will see me every Tuesday to examine my skin and see about the side effects
I then went in a room where a master mind tech measured, took pictures, and tattooed me. I have 4 small blue dots but havent looked yet exactly. That took an all of 20 minutes. In case some of you dont know, you hold on to what I call handle bars behind you while you are laying on your back and have to keep VERY still. My left arm was hurting bad. Have a hurt muscle there. He finally "unglued" me then the tech massaged my shoulders for a little bit. That felt good.
Tomorrow, I am going to Julian in the morning, and in the afternoon at 2:00 I have to go for a cat-scan so the onc. can see where my heart and organs are in relation to my left breast. Next Friday the 16th, I go back to the tech for the long pre-lim set up that lasts an hour and the hands will go on the handle bars again.
After that, on the 19th I have a "dry run" to see how everything is and if they need to tweak anything. Then, on the 26th, I get my first ZAP. Im scheduled for 33 and looking at my schedule here cause they are nice enough to give you one, it looks like 1/11/08 is my last one. The last 5 Zaps are boosts which means they will concentrate on the incision part only. Since they are open only from 7-3:30 (because they dont have too many patients right now), I have all mine scheduled for 7:30 (UGH).
I am sure glad I had this time off to get set up. It would have been a hassle for me to be at work and then be out half the day for the appt I had today, and the cat scan I have tomorrow. Looking at this schedule it seems to confirm it for me. True, I dont like to go to work anyway BUT there is alot involved here.
I hope everybody is well because it looks like everyone skipped a day.
How are you holding up maa?
I brought a little tube of "jeans cream" that I am planning on using and he said thats fine. Her website is jeanscream.com Its got aloe vera and vit E. I told him I wanted to join the Y on Friday and he said thats fine but to not go more than 3 days a week because of the possible fatigue. We talked about walking and Ive been doing it since the 1st and he said that will actually help with the fatigue. Nothing too strenous (sp.). He said dont take Vitamins A, C and E but that a mulit vitamin is fine. Once we get started, he will see me every Tuesday to examine my skin and see about the side effects
I then went in a room where a master mind tech measured, took pictures, and tattooed me. I have 4 small blue dots but havent looked yet exactly. That took an all of 20 minutes. In case some of you dont know, you hold on to what I call handle bars behind you while you are laying on your back and have to keep VERY still. My left arm was hurting bad. Have a hurt muscle there. He finally "unglued" me then the tech massaged my shoulders for a little bit. That felt good.
Tomorrow, I am going to Julian in the morning, and in the afternoon at 2:00 I have to go for a cat-scan so the onc. can see where my heart and organs are in relation to my left breast. Next Friday the 16th, I go back to the tech for the long pre-lim set up that lasts an hour and the hands will go on the handle bars again.
After that, on the 19th I have a "dry run" to see how everything is and if they need to tweak anything. Then, on the 26th, I get my first ZAP. Im scheduled for 33 and looking at my schedule here cause they are nice enough to give you one, it looks like 1/11/08 is my last one. The last 5 Zaps are boosts which means they will concentrate on the incision part only. Since they are open only from 7-3:30 (because they dont have too many patients right now), I have all mine scheduled for 7:30 (UGH).
I am sure glad I had this time off to get set up. It would have been a hassle for me to be at work and then be out half the day for the appt I had today, and the cat scan I have tomorrow. Looking at this schedule it seems to confirm it for me. True, I dont like to go to work anyway BUT there is alot involved here.
I hope everybody is well because it looks like everyone skipped a day.
How are you holding up maa?
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