16th February - Results of Sentinel Lymph Node Biopsy

Had a lovely birthday on Sunday. They sang Happy Birthday to me in church. Made me cry..
Friends visited, and we had a really good family dinner together - Bill cooked a lovely roast.
Mum and Dad had planned to visit me on Monday - even after Dad's nasty turn last Tuesday.. but then - Mum cancelled because my poor dear Dad had become violently sick on Sunday afternoon. Could be the Norovirus? Andy came over anyway. It was great to see him, and now he's gone off to his Mum's for the week.

This morning Jean took me to the appointment. The results of the sentinel lymph node biopsy are: they removed 5 lymph nodes; one was cancerous. This means:

• they will remove all the lymph nodes when they do the mastectomy.


• they will count how many are cancerous after having removed them


• if more than 3 are cancerous they will definitely want to do radiotherapy because without it there is a much higher chance of cancer recurring in the breast


• radiotherapy is done before reconstructive surgery


• I will have 2 operations - one mastectomy, and then, much later - reconstructive surgery to balance my shape, if wanted (! hah!)

Since I have cancer in the breast and lymph nodes, they are hunting it elsewhere too. Next week I get a bone scan, a liver scan, a chest x-ray and some blood tests, because if breast cancer metastasises (spreads), it usually goes to the bones, liver and lungs.

I asked about the likelihood of needing chemotherapy (which would come between mastectomy and radiotherapy typically), and I came away with the impression that this is likely, though in what form is not yet known.

They looked at my armpit scar and I pointed out the horrible tight 'cords' which have appeared which limit movement and cause pain. The nurse said something about physiotherapy. I looked up these tight 'cords' online at home - it's now called axillary web syndrome and is a common occurrence after axillary node biopsy. Sometimes it doesn't go away. It is a risk factor for lymphedema. I was told to keep exercising and stretching even though it hurts.

There isn't really a choice as I see it. I asked about other treatments, radiotherapy during surgery, lumpectomies, and was advised that there isn't really much choice in my situation, with my size tumours, and little areas of abnormal tissue in my size breasts. I could risk opting for a mastectomy with immediate reconstruction - hoping hard that the axillary node clearance brings up no more than 2 more cancerous nodes (which is the threshhold level for radiotherapy being given post-operatively). But that's gambling. It would be a painful shame to see good reconstructive work go to pot with the damage that radiotherapy would do to newly grafted tissue and implants.

I am therefore having a mastectomy without immediate reconstruction, and the axillary node clearance on the 19th March. That's the earliest my surgeon can do. I have to visit the Fit For Surgery folk again before then to be deemed fit. (hmm.. if I were fit, I wouldn't need surgery!!) Last time they saw me they made a real hash out of getting blood samples, their receptionists were grumpy and unhelpful, and they don't even try to keep waiting times down. So I didn't stay today to be assessed, ("take a number, about an hour's wait, love") but made an appointment for first thing on March 5th. Surely they won't be running late with their 1st patient of the day?

So, not to worry. Came home, Jean and I got stuck in with pancake making for children's brunch, rearranged my farm, shopped at Asda. I'm thinking Chilli Con Carne for tea..I see they're getting Colombian bananas in now. But we always buy the Fairtrade...