Wednesday, February 08, 2006

WHO NODES?

How quickly we fall into jargonland... Just think, less than a month ago I didn't even know what a node was, let alone care if it was positive or negative... to clarify, "nodes" refer to lymph nodes. From my (limited) understanding, this is the first place that breast cancer cells spread to (typically the ones under the armpit), and the extent to which and number of nodes that are affected help to "stage" or define the extent of the disease and spread. "Node negative" means that there has been no spread to the lymph nodes and the cancer likely hasn't spread. "Node Positive" means that one or more nodes has tested positive for cancer.
During surgery, they identified and did initial testing on my "sentinel" nodes-- the lymph nodes that the dye/radioactive tracer injected into the tumor were shown to travel to first. If these are negative, there is a high probability (>95%) that the cancer has not spread anywhere else. Typically this also means that a full auxiliary node (i.e., all the nodes under the armpit) dissection/removal is not necessary-- which is what I had hoped for initially, because it's a less invasive surgery with fewer long-term effects. However, the PET scan showed enough potential abnormalities that the surgeon opted ahead of time to do the full auxiliary dissection (which turned out to be 9 nodes removed from me-- it's different for everyone, isn't that odd?... I think the average is something like 15)
The "on-site" sentinel node tests showed that my nodes were negative, indicating that the cancer had not spread anywhere, which is why I was so happy. However, the on-site testing catches everything about 80% of the time. Further pathology found some "micrometastese" (0.3mm) and a few random cancer cells in my sentinel lymph nodes, and (I'm fairly sure about this but not certain) nothing in the other lymph nodes. So basically I'm somewhere between positive and negative... (Node neutral?) The good news about this is that even though it was there, it's not much... and more importantly, I didn't have to make the hard decision about whether or not to go back into surgery and get the rest of my lymph nodes removed/tested-- because even though they are negative, I wouldn't have known that for sure.
I asked the Doctor if she would consider me "cancer free" since the tumor and the lymph nodes have been removed. She told me: "I can't say you're cancer free until you're dead-- and not necessarily from cancer." I appreciate her candor, but I have to admit that that statement has kept me up a night or two thinking about that rogue cell hiding somewhere in my body. But everyone has that same risk. Not everyone has a PET scan that shows an all-clear everywhere else, and even better, not everyone is going to get chemotherapy with the intention of hunting down and knocking out any (hopefully nonexistent) rogue cell. So there.

1 Comments:

At February 09, 2006 12:58 AM, Blogger Nichole said...

yay for node nuetral!!

 

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