Sentinel Node Biopsy – How They Mark The Spot

I have to admit I was a bit apprehensive about this part of my medical testing. (As if you hadn’t been poked and prodded enough already…they are going to do it just one more time.) I’d heard from others who had been through it that it could be extremely painful..

But then again, most people found the biopsies painful, too. In fact, my boob was a deep purple where they took the biopsies. And I couldn’t raise my arm above my head now. The actual test didn’t bother me at all. So, I kept that in the back of my mind as I was wheeled down to Nuclear Imaging.

A word to all hospitals:  You really need to do something about your ceilings.  I think you need to lie the head of Maintenance and Operations, and the Hospital Director on one of those gurneys and wheel them around the hospital so they can view the ceiling tiles from the same position we patients do.  Honestly, you wouldn’t put up with those cracks and stains in your house, why should you put up with it in your workplace?

Do you know what we patients imagine that those stains are?  Hmmmm??  Honestly, you probably don’t want to know the answer to the question. Take care of that please. 

Anyway, I was delivered to Nuclear Imaging room.  After answering the questions of my name, birthdate and what kind of surgery I was having, the procedure was explained to me. 

They will inject the cancerous breast with radioactive isotopes, and then for the next hour I will lie under a camera, which will take photos of the isotopes’ path through the breast/lymph system.  The first place the radioactive goop will settle are called the “sentinal nodes.”  That area will be marked so the surgeon knows which nodes these are, and those will be removed during my surgery and biopsied right away to find any cancer cells lurking within.  If the answer is no cancer, I’m done.  If yes, then they go in and take more through an axillary dissection to see how much spread there is.  The axillary dissection often leads to a difficult lifetime condition called lymphodema, which fortunately is much rarer in those who have the sentinal node biopsy. 

I was happy to hear the tech told me that he would be injecting lidocaine into my breast first.  Since they inject it directly into the nipple/areola complex, lots of people who had it done had said it was horribly painful.  He assured me that he used the smallest needle possible and it shouldn’t feel more than a pinch.

He was right, I felt the first needle pinch which wasn’t painful, and after that, nothing.  He was a master.  I had to massage my breast to get the stuff to spread around, which was weird because it was numb and I couldn’t feel anything.

Then they got me on this skinny little table to position me under the camera.  Now, I don’t want to be indelicate here – but I fit on that thing, just barely. It was maybe 15 inches wide and slightly curved up.  My arms could not fit on the table, just my back.  And, I weigh only 140 pounds.  So, I wonder, how uncomfortable is that table for a person who weighs, oh, say…200 pounds?  Or more?  Not only did I have to lie on that skinny table for an hour, but I wasn’t allowed to move.  At all.  Period.

Well, you know what I did, right?  I went to sleep. I was bored…that was the best way to end the boredom.

When it was finally over, I was awakened by a female tech who said, “You are cute!”  I said, “You are too!” and she totally was.  We struck up a friendship immediately.  She told me all about her cousin who had a mastectomy but her cancer had come back and this time was going through chemo, and a hilarious story about a fake boob floating away at the beach.  She also is a big fan of wigs,  she likes to change it up, and gave me lots of tips on wig shopping.

They have this amazing high tech way of marking the sentinal node for dissection.   The female tech went over to the computer monitor and looked at where the node was.  He came over, stuck his finger in my armpit and said, “Here?”   She’d check the images and would say, “Nope, over to the left a little,” and he’d move his finger and say, “Now?”  “No, up just a bit.”  They did this until she could see the shadow of his finger on my node.  When she finally said “yes, you got it.” he took out a pen and marked it with an X.

I believe that is what is called “state-of-the-art.” 

Word was sent down that a doctor was looking for me, so they readied me for transport, Cute Tech making me promise to come back and show her my wigs if I had to get some. This didn’t happen because I didn’t loose enough hair to warrant a wig.

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