Breast Cancer and Your Lymph Nodes

PJ Hamel Health Guide
  • Waiting. You do a lot of it when you have breast cancer. Anytime you’re at the doctor’s office, or in a hospital, guaranteed you’re going to spend some time sitting in a chair with some very well-worn magazines, waiting your turn to get blood drawn, have radiation, see your oncologist.

    That’s one kind of waiting. The ho-hum, big yawn, wonder what I should make for dinner tonight waiting. But there’s another kind of waiting, and it’s much more stressful: waiting for test results.

    We’ve all been there, right? Starting with the biopsy. Benign, or malignant?


    Then there's the lumpectomy. Clean margins… or not? Bone scans, MRIs, blood tests, all involve hours or days of waiting while you put your life on hold. You can’t plan too far in advance, since you don’t have any confidence in the future until you GET THOSE RESULTS.
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    Waiting to hear if breast cancer has spread to your lymph nodes is one of the really key stress-builders we go through. Was the cancer contained? You can breathe a sigh of relief and get on with your radiation. But if cancer has left your breast and started to move around your body, uh oh… That usually means chemo. And bumping you up to at least stage II, often higher. It means your chance of recurrence has suddenly taken a giant step in the wrong direction. And emotionally, it rips that security blanket right out of your hands: “I’m sure they got it all.” Or… not.

    The wait to hear if cancer has spread to your lymph nodes has traditionally been at least several days, often longer. Try as you might to just go about your normal routine, that little voice in your head never stops. “What if it’s spread? What’ll I have to do? Will I worry the rest of my life about it coming back?” It’s nerve-wracking, to say the least. But a recent advance in lymph node testing may just shorten that wait time considerably.


    Sentinel Node Biopsy. The standard of treatment currently is for the surgeon to take a small section, typically 5%-15%, of the lymph node closest to your cancer; the sentinel node, the place where, if your cancer has spread, it’s most likely to have landed first. That tiny piece of lymph node is brought to pathology to be examined under a microscope for evidence of cancer. But here’s where the waiting starts: it’s not like the pathologist is sitting around twiddling his thumbs till YOUR specimen arrives. Nope. You have to get in line, and that can take several days, sometimes even weeks. If it’s finally determined there’s no cancer in the lymph node, fine; but if there is, you have to return for another surgery to remove more nodes. And all that time you were doing some serious, stressful waiting.

    Now, there’s a test with a much quicker turnaround time. Approved by the FDA on July 16, the GeneSearch BLN Assay detects cancer in lymph nodes on a molecular (rather than cellular) level; and it does it within 35 to 40 minutes, while you’re still on the operating table. If cancer is detected, the surgeon can remove more lymph nodes immediately, rather than wait for results and then possibly have to schedule another surgery days later. And, just as important, you can get the news–good or bad–before you even leave the hospital. No waiting for the pathologist’s report; much less time wondering “what if?” And that’s a good thing.
Published On: September 05, 2007