Lymph Node Involvement in Breast Cancer: All You Need to Know 

Our pleasure. Our bodies are amazing.

Can I ask is it possible to have a breast lump and lymph node (sentinel area) larger and it not be breast cancer?

@@yerbba I didn't know that. I had 16 of them removed and 14 were involved.

I never did either, and they weren't taking them out if they really don't have to. When they take em out it's brutal it's worse than the cancer you end up with lympheadema so I never heard they grew back. It's your immune system!?

Wow, and I pray your doing well

It's amazing what our bodies are capable of! While the lymph nodes that have been removed won't grow back, your body will "recruit" additional lymph nodes.The lymphatic system is incredibly adaptable.

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Great question. Supraclavicular lymph nodes used to be classified as Stage IV disease. Then it was found that many people were being cured with systemic therapy and radiation therapy. This led to supraclavicular lymph nodes being reclassified as N3 and the overall stage as IIIc (3C). Yes, this is a serious illness but not without hope of cure.

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We’re so glad you found the information informative and thorough!

Good question. It is unlikely that someone with negative sentinel lymph nodes would have other lymph nodes that are positive. In someone with clinically negative lymph nodes (non-palpable, no enlargement or other abnormality on imaging studies), the likelihood that this would happen is very low.

This is a great question. One would expect that any side effects from the medication will resolve and go away after a couple of weeks to a couple of months. Most people find the hot flashes and similar side effects get better first.

Any cells in the lymph nodes are well embedded in the tissues. As far as we know, vigorous exercise does not dislodge cancer cells from the lymph nodes.

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Thanks for the question. There is no relationship between sciatica and cancer unless someone has recurrent cancer that compresses the sciatic nerve. This is extremely uncommon.

Thank you for your question. Extranodal extension is associated with a higher risk of recurrence, which is why we give radiation therapy. In someone with positive lymph nodes, with or without extranodal extension, radiation therapy is considered.

@@yerbba I appreciate that you answered my question. I’ve had surgery, radiation and I’m on anastrozole. 1 lymph node positive and clean margins. Oncotype was 14. Before this I thought I had 20-30 more years but now I take one day at a time!

My pathology report noted both extranodal extension and lymphovascular invasion (Stage 3, 11 positive nodes because the original tumor was actually under my arm, not on the breast) Because of this location I just assume I have a high risk of recurrence. Would I be able to stay on a targeted therapy long-term??

Thanks for writing. In general, for people over 70 years of age with a tumor like the one you're describing, there is compelling evidence that lymph node assessment is not necessary.

@@yerbbahow about people with the same type of breast cancer stage 2 with axillary lymph nodes (1) involvement, should I get removed them and do radiotherapy?

We'll start with your second question first. The surgeon identifies the node or nodes that take up the blue dye or, in some people, the radioisotope, by looking at the lymph node with the naked eye. The pathologist is the one that identifies the actual nodal tissue and whether or not the lymph node(s) is or are positive under the microscope. Sometimes the lymph node may be enlarged or hard, both of which may indicate that the lymph node is likely to have cancer. For your second question, a negative lymph node after chemotherapy is a good sign, but the amount of tumor in the breast is also important in helping estimate a prognosis.

We're so glad our videos have been helpful for you to understand your breast cancer better. With your stage one diagnosis and HER2 positive status, it's great that you're following a comprehensive treatment plan to manage the genetic risk of recurrence. Keep up the proactive approach to your health. Thanks for watching!

You're very welcome! We're glad to hear that you found the information helpful, and it's great to know that you're a 1.5 years cancer-free. Your proactive approach to maintaining a healthy lifestyle with a clean and green diet is commendable. Thank you for being part of the Yerbba community!

Good luck with a healthy life 👍

It would be worth showing your doctor the lymph node that you're noticing. This is not a typical place where lymph nodes show up related to breast cancer, but it never hurts to check.

Great question. This finding on imaging may mean that there are cancer cells in these lymph nodes. In general, the treatment given for the other sites in the body will treat these lymph nodes as well.

Our bodies are amazing, and it's not uncommon for people who have a second lymph node dissection after a complete dissection in the past to have lymph nodes that were not there previously.

Good questions, and there is of course a lot of interest in these questions. It's important to differentiate between the lymph nodes and the immune system. The lymphatic system is only part of the immune system. Immune cells are present throughout the body, including the blood and the tissues themselves.

Thank you for your kind words! It's never too late to seek answers, so please feel free to ask your questions.

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We're not quite sure what you mean and we agree that doctors need to be honest with their patients. Some patients do not want the "whole truth," so it's important for doctors to ask what type of information the patient wants.

Thanks for writing. Without being part of your medical team, it is difficult to know if these lymph nodes are related to cancer and what is causing your pain. If possible, seeing your primary care doctor is likely to be the next best step. If you have a known diagnosis of cancer, your cancer team can also help.

The role of ctDNA is not entirely clear regardless of the stage of disease. There are no studies showing that outcomes are improved in people who have ctDNA testing done.

So hard to have such long term effects. Physiotherapy can be highly effective in helping with the types of problems you're having.

Have you gone on line and check out the message therapies to do and the Ti chi versions this im told is the only hope with lymphedema.... I have a problem as well, but it's weird sensations and extremely weak, and I was very strong, now 2 pounds feels like 30pds. Good luck , and praying helps .

Thank you for sharing. It's important to give yourself grace during this time and focus on your healing. Make sure to follow your healthcare team's advice closely, stay hydrated, and rest as much as possible. Wishing you a smooth and gentle recovery.

Thanks for writing. Without being part of your medical team and having the ability to examine you, it is difficult to render an opinion. The best guidance we can give is to see your doctor soon.

People with cells that have not broken through the capsule may have a lower risk of locoregional recurrence.

The pathologist is rarely in the operating room with the surgeon. Space limitations and concerns about maintaining a sterile environment make it difficult to add in another person with the required equipment. In places where the pathologist and operating room are near one another, the sharing of information is seamless and prompt.

Thank you for writing. We cannot provide medical advice without being part of your care team and would encourage you to talk with your medical team.

The side effects last for a variable amount of time. You may find our video on the duration of chemotherapy side effects helpful. If you have other questions, come back and let us know. ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-smdh7F_WNYA.html

This does sound confusing. We hope you can ask your team about the decision-making process. Thank you for watching!

We understand this must be a concerning time for your friend. It's important to note that while these findings could be related to various conditions, including non-cancerous ones, it's crucial for them to consult with a healthcare professional for a thorough assessment. Encourage your friend to share their concerns and feelings with their medical team, who can provide the necessary guidance and support during this process.

Yes, we are using the AJCC 2018 staging system.

It didn’t seem that you were by stating the size of the tumour and nodes, the 8th edition came out January 2018, there will not be a 9th edition however a 9th version digitally, there’s an app called Oncoassist

Radiation therapy is actually given to decrease the risk of recurrence in the breast and neighboring (regional) lymph nodes. Radiation therapy in your case does not decrease the risk of cancer returning in other parts of the body. Even if the surgical margins are clear, radiation therapy decreases the risk of the cancer coming back in the breast after surgery.

@@yerbbathis confuses me. Radiation doesn’t decrease the risk of it reoccurring elsewhere and yet it dii or es decrease the risk of it returning in the same spot. Yet mine is slightly w growing and doc says I have 10!years risk free. At 78 dies radiation make sense? ?

Hardened lymph nodes can be a sign that your immune system is responding to something, such as an infection. It’s important to have this checked by your oncologist to determine the exact cause.

Facing a diagnosis of stage 3C triple-negative breast cancer (TNBC) is undeniably a significant challenge. It's completely normal to feel a range of emotions, including difficulty in acceptance. Remember, you're not alone in this. There is a community of support here for you. Thank you for watching.

@@yerbba Thank you for what you do and the positive spirit you have.

You are asking great questions, and we can sense the emotion behind your questions. Angiolymphatic invasion, also called lymphovascular invasion or LVI, is not related to lymph node status. You may want to check out our video about angiolymphatic invasion here: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-VvNRJc7jN6o.html There is important work about cancer stem cells and treatments directed against cancer stem cells. For our other viewers, cancer stem cells are a distinct subpopulation within tumors that exhibit stem cell-like properties and are believed to play a crucial role in tumor initiation, progression, and resistance to conventional therapies. It is not possible to determine which cells are stem cells from a tumor. Antibody-drug conjugates and other therapies are offering great promise. Some people with so-called favorable breast cancer can indeed have a recurrence and eventually die from their cancer. You may find our video on why we haven't cured cancer to be helpful: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-fLcq25CvtcM.html People with pure DCIS who die of breast cancer most likely had invasive cancer that was not detected in the tumor specimen. This is exceedingly rare.

Hi deborah and Dr. Riggs, if deborah had a mastectomy instead of a lumpectomy, do you think she could’ve been cancer free?

How are you now deborah? I’m also diagnosed with invasive ductal stage 1 grade 2. After Mri was called in, I found out that 2 of my lymph nodes are enlarged. Do I need to be concerned that my cancer has spread in my lymph nodes?

I actually had a lumpectomy first,2.0 centimeter in late 93.With one to several lymph nodes involved you should be o.k.,with proper treatment.Mine recurred in the axillary area,and skin which is a more serious condition.

Thank you for opening up about your incredible journey. Facing stage 2b breast cancer and now navigating through a stage 3 diagnosis after a period of no evidence of disease must have its own challenges. We're here alongside you, and if there's anything more specific you'd like to learn about, please let us know.

@yerbba Dr.Griggs thank you for all that you do to help us understand breast cancer.After having 18 lymph nodes removed,and only a small amount in one 30.5 yrs.ago.I thought I wouldn't ever have a concern in my axilla area.So 4 yrs.ago the cancer recurred as a 1.5 cm.tumor,with an inch of skin involvement.What a surprise since it was not in my lymph nodes.Anyway,I did have radiation with 10 boost extra,because of not having clear margins in Nov.93.Thank you again for helping everyone on here.

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