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enlarged lymph node 3 years after treatments

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elizabeth View Drop Down
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    Posted: Aug 18 2010 at 9:15pm

Hi everyone,

I am 3 1/2 years out from TNBC diagnosis, went through surgery, sentinel lymph node biopsy (node negative), chemo, rads, etc., and just learned from an unrelated CT scan that I have an enlarged axillary lymph node on the side where the original tumor was found.  It is still relatively small (6mm by 5mm) and the oncologist did not feel it in a recent clinical exam. 

The doctors want to do a "watchful waiting" approach -- they ordered an ultrasound in 6 months to see if the lymph node grows.  Does that make sense??  I am very worried that if it is a TNBC recurrence, it could grow quickly (original tumor was high grade) and become a much bigger problem (systemic metastasis) within the 6 months.

I just found a study showing that negative hormone receptor status and high tumor grade may be risk factors for axillary recurrence after a negative sentinel lymph node biopsy:
http://www.ncbi.nlm.nih.gov/pubmed/20162458

I am getting pretty nervous about this.  Any thoughts or advice?

Elizabeth
lumpectomy 4/07; 1.8cm TNBC stage 1c grade 3; chemo: AC, Abraxane, Avastin; rads 9/07; bilat mastectomies 9/08; oophorectomy 1/09.
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123Donna View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Aug 18 2010 at 9:44pm
Hi Elizabeth,

Can you tell us where you are getting treatment (state)?  Would you consider another opinion?

I agree with you that TNBC is a tricky devil and shouldn't be taken lightly.  Can they do a biopsy of the node to see if the cells are cancerous?  6 months seems like a long time to watch and see.

During your 3 1/2 years, did you have any other scans (CT or PET) to monitor for recurrence?  Was this caught by accident or have you had any other symptoms?

I'll be hoping it's just B9, but be aggressive in seeking out the answers you need.  Please keep us posted on how you're doing and what you find out.

Hugs,

Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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denise07 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote denise07 Quote  Post ReplyReply Direct Link To This Post Posted: Aug 18 2010 at 9:45pm
I dont think I would wait. Cant they remove it now so you dont have to wait and worry?
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123Donna View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Aug 18 2010 at 9:46pm
Elizabeth,

One more thought.  Could it be some type of infection in the lymph node?  Did the onc offer any suggestions on other possible causes?

Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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dmwolf View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: Aug 18 2010 at 9:59pm
What torture.  I think waiting for 6 months would make me nuts.  If they could just pop it out, I'd probably want to do that, unless by chance you have had an infection recently or some lymphadema in the axilla.  Then I'd hope it was just an infection and wait and see.  Let us know what you decide, and {{{hugs}}} to you.
love,
d
DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Autumn10182001 Quote  Post ReplyReply Direct Link To This Post Posted: Aug 18 2010 at 10:03pm
I would NOT wait... have them do a biopsy on it NOW... that way you will know for sure...
DX2/99 Stg I,ER+PR+ Chemo lumpectomy - Neg nodes,rads, tamox,femara. DX4/09, Stg IIB /III, TNBC IDC, Grade III, 2.5CM, mastectomy. 4AC DD,12 wkly taxol,BRAC1&2Neg, Right Mast 11/25/09
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Aug 18 2010 at 10:06pm
A biopsy seems like a simple procedure.  Why not do it and learn the results?  Are there any risks to biopsying the node?  I think that's what I'd do as soon as it could be scheduled.

Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Post Options Post Options   Thanks (0) Thanks(0)   Quote TNBC_in_NS Quote  Post ReplyReply Direct Link To This Post Posted: Aug 19 2010 at 9:25am
Yes, me too for the biopsy!  Life can be so tortuous some times.  All this time out and now the enlarged lymphs..again...
 
This disease is out of control! When will we get some new techniques for getting rid of this for good?
 
Hugs to you and be a good advocate for yourself,
Helen in NS
Diag@57TNBC04/092.5cm Lquad 05/09 TCx4Radsx30CT03/01/10 FU03/31/10ClearBRCA- 01/2011 RTNBC BMX 06/14/2011~2013 clear
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diane1234 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote diane1234 Quote  Post ReplyReply Direct Link To This Post Posted: Aug 19 2010 at 9:42am
NO....NO....NO......NO...... DO NOT WAIT. I pray it is NOTHING, but HOW does one know that unless they PUSH to find out it is NOTHING. I have learned through my journey, that the medical field seem to classify breast cancer as ONE disease. IT IS NOT!!!!! I was only about 10 weeks post treatment. I called and presented my Oncology Nurse with pain in my shoulder. She proceeded to tell me IT IS MUSCULAR......I need to get on with my life. IT IS TOO SOON FOR ANY RECURRENCE, and maybe what I was dealing with is PHSYCOLOGICAL.....but If it would make me feel better,  then she would set the scans up. I said YEP...it WOULD make me feel better. She called with results and was nearly SPEECHLESS.....She actually said DIANE I WOULD HAVE BET MY HOUSE ON THE FACT YOU WERE CANCER FREE!!!!!!! Well good thing she is NOT A GAMBLER....I now attend CTCA in Chicago, IL....I do NOT want to scare you, but I do want EVERYONE to know that we MUST be our own advocates. Yes I believe there are some wonderful Doctors, BUT they are HUMAN.....Please DO NOT WAIT.....Trust me TRIPLE NEGATIVE DOES NOT WAIT.....Again, I PRAY it is infection.....Lymphadema.....or ANYTHING ELSE. (((((((hugs))))))))
 
May God Bless Us All,
Diane
dx 4/09 at 36 yrs old. dbl Mast. 5/09. 12 weekly Taxol 4 FAC tri weekly. 32 rads completed 2/2010. Its Back 5/2010!! Chest wall, Mediastinal node, Lft mammary node and liver. Back on chemo.
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outnumbered View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote outnumbered Quote  Post ReplyReply Direct Link To This Post Posted: Aug 19 2010 at 9:59am
I do not wish to alarm you, I have experience in this exact situation,  PM me if you would like details, but you really NEED to DEMAND an excisional biopsy ASAP.   

Edited by outnumbered - Aug 19 2010 at 10:01am
~Sara

DX @ age 40 6/24/08 Stage 1 Grade 3 BRCA1+ 187delAG

BMX (nipple-areola-sparing) 8/5/08

Redo BMX (remove nipple and areola) w/ Lat Flap 7/6/09

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Post Options Post Options   Thanks (0) Thanks(0)   Quote nmunoz Quote  Post ReplyReply Direct Link To This Post Posted: Aug 19 2010 at 3:37pm
Hi Elizabeth,

Maybe if your doctor's don't want to be too radical why don't you ask them to do an ultrasound guided needle biopsy? I had one of those to check an enlarged lymph node that showed up in my underarm where I wasn't supposed to have a little more than a year ago. It is not that invasive and they try to get enough samples using the needle to allow them to check the cells in the lymph node. But do get some kind of biopsy soon. When I told my BC surgeon that I was feeling a lump in my underarm and she felt it too she walked me over to radiology herself and arranged everything for me to have the biopsy done right away, on that same day. She said she didn't want to take any chances.

I hope all goes well with you.

Best,

Natalia
Natalia, 38 years

Dx TNBC 10/22/08, BRCA1+

Double Mx 11/20/08 with Recon.

3/37 nodes

Rads 7 weeks done 8/09

ACx4 every 2 weeks and Tx12 weeks. Avastin e/3 weeksx10 (Clinical Trial) Done Dec/09
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