Lymph Node Spread: Does it Mean Advanced Breast Cancer?

[@ghlmk5931]

I saw the word metastatic in my pathology report and almost had a heart attack. It took a few frantic minutes to realize that there was no way for the pathologist to know it had spread to the rest of the body without a PET or CT scan and that it meant only the lymph nodes. I think the word metastatic should be removed from pathology reports, especially now that patients can see those reports online almost instantly, before their physician does. Thanks for the video.

[@damaris2085]

I agree, I also experienced this when I received my initial diagnosis. My heart dropped when I heard the doctor say this word and when I read it on my diagnosis paper . I had 1 lymph node involved, but it definitely was scary to hear the word.

[@yerbba]

Thank you for sharing your experience. We completely agree and are working on making this change. You’re right that more clarity in these reports would help avoid a lot of unnecessary stress, especially with instant access online. We're glad the video helped!

[@_ShiningStar_8]

Thank you so much for your channel…i found you when i felt lost after i have been diagnosed with breast cancer.. I watched nearly all your videos to get more information to as what cancer is and what’s next … sometimes I go to cancer clinic and nurses does not mean they can tell you everything… sometimes when you book an appointment to see a nurse.. your mind goes blank and don’t know what to ask…I find a lot of videos in u tube can be overwhelming n it makes you feel even more worried n confused but your videos are informative but simple and straight to point…it does not make me feel scared or confused and I feel it helped me so much …cancer is a journey… we have our ups n downs.. it changes your life completely… anyways thank you so much for your channel..n I appreciate your effort in providing genuine information to help people all over the world… and to all the people just diagnosed or on this journey… never feel alone…❤we are all in this together❤️

[@yerbba]

Thank you so much for your kind words and being part of the Yerbba community. Cancer can be overwhelming, and we know exactly what you mean about freezing up at appointments. It’s true that the journey is full of ups and downs, but you’re right-you’re never alone in this. We’re all in it together, and we're grateful the videos have helped make things a little clearer for you.

[@dianeabell5782]

As always, thanks. I am a 73 yo woman who was recently diagnosed with T1bN0M0 BC with a 6mm mass found on my right breast via a screening mammography. This is so tiny, and I feel so fortunate that I went for the mammo. The interesting thing though, is my surgeon has opted not to do any axilla surgery, basing his decision on the Society of Surgical Oncology Choosing Wisely Guidelines, wherein he feels, along with the guidelines, that there is no added benefit to removing any lymph nodes. I have read the guidelines, and it seems that there could be a very small chance of recurrence, but because of my age, it may not matter. Fact is, I am thrilled that I’m not going through with this aspect of surgery, which is scheduled for September 30th. This is something you have never discussed, as far as I can tell, and I’d like to hear your take on this, either in the comments here, or in a future video. Again, thanks for all you do for those of us tethered onto this medical merry go round.

[@chetnakalelkar6700]

I have had a similar case where I did go for mastectomy but no lymph nodes were removed. Following....

[@yerbba]

With a tumor that small, we have ample evidence from randomized trials in people who are 70 and over with small tumors that a lymph node assessment is not beneficial. We hope this is helpful.

[@SofiaAhmad-rp8sm]

Thanks for the information, your advice make me cool my heart and brain.i diagnosed breast cancer stage 3 with lymph nodes involved

[@yerbba]

We're so glad the video helped bring you some comfort.

[@heatherdufault6578]

Dr. Griggs, you speak about cancer "moving" from the breast to the lymph nodes. But in my case, I don't know if it would be fair to say the cancer "moved"--because the tumor itself was in my armpit; in fact the pathology report noted it was "challenging" to determine the exact size of the tumor, because there were involved lymph nodes literally sitting on top of it! Does this indicate that the prognosis for axillary cancers such as this are going to be automatically poorer?

[@naththomas9946]

Thank you, Dr. Griggs, for your continuous support and promotion of breast cancer (health).

[@yerbba]

Thanks for being part of the Yerbba community!

[@teresathornhill4407]

Thank you this was very informative I was diagnosed with breast cancer in November of 2023 and since have had a mastectomy and a lumpectomy and I’m currently in radiation treatment and my lymph nodes were positive for metastasic breast cancer I have had so many questions and concerns since my journey began there were 3 types of cancer involved in one breast only and the lymph node and trying to understand it all can be very overwhelming.

[@iconic1758]

Why didn't you recieve .chemo?

[@iconic1758]

Why didn't you recieve chemo???

[@iconic1758]

Why didn't you recieve chemo.

[@yerbba]

Thank you for sharing your experience. We can imagine how overwhelming it must be to process everything, especially with multiple diagnoses and treatments happening all at once. It’s completely normal to have a lot of questions and concerns during such a challenging journey.

[@quasimodem5260]

Sometimes I am afraid to watch information such as this and wait till I am in the mood to hear. Thanks for posting this, it put things in perspective. I had on micrmestatic node removed and received 5 extra rads on that area following my lumpectomy. Today I am still concerned but not as scared. Thanks so much.

[@yerbba]

It’s completely normal to need time before diving into information like this-sometimes it can feel overwhelming. We're really glad the video helped put things into perspective for you, and that you’re feeling less scared today. You’re doing an incredible job navigating all of this.

[@Cheryl-t7b]

Dr. Griggs, thank you so much for clarifying this. I was diagnosed in August, and I wasn't able to do the MRI they scheduled, so I still don't know what my lymph node status is. It's good I saw this video because now I'll have a little bit of foreknowledge on this subject. Thank you so much.

[@yerbba]

We're glad the video provided some insight! It’s understandable to feel in the dark about lymph node status without the MRI, but being informed can really help you feel more prepared.

[@pbj91]

My cancer center only biopsies the sentinel nodes. I had 1 positive out of 3. They do not remove more and biopsy more because they say axillary lymph node removal leaves women with a great risk of lymphedema. They recommend radiation of the axillary area if any sentinel node was positive. Do you agree with this approach? I see women who say they had up to 20 positive nodes, but I’ll never know how many nodes I had positive beyond the 1 sentinel. I have to hope radiation took care of everything (they also refuse any scans for early stage breast cancer which is up to Stage 3A)

[@damaris2085]

@@pbj91 Im currently going through a similar situation. My initial diagnosis included 1 positive lymph node (stage 2 with a 4cm tumor). I had 16 rounds of chemo and they said only residual from tumor was left in my breast area. I had my mastectomy on the 21st of this month and was told everything went as planned. I went back for my lab results and my surgeon said that out of the 5 nodes she removed, two came back positive and a third had 1 cancer cell. I obviously didnt want a 2nd surgery 2 weeks out from my mastectomy, but she explained to me that she didn’t feel safe not testing more lymph nodes because radiation will kill micro cells but not necessarily a whole infected lymph node. She basically said, I have to go back in this week and grab more just to give us peace of mind that all the chunks of cancer are gone (full infected lymph nodes). My surgeon also mention that this is protocol for her and that even if only 1 lymph node is positive she goes back in just to be safe until lab results come back completely negative. Hope this information helps.

[@pbj91]

@@damaris2085interesting. I don’t understand how every place has a different protocol. I’m at Memorial Sloan Kettering and was told by the radiation oncologist that if there is any cancer in the lymph nodes, beyond the 1 positive sentinel node I had, it will not survive radiation

[@damaris2085]

@@pbj91 Yeah, I dont like that everyone is told different things. My surgeon told me that she didnt feel comfortable leaving any lymph node with more than 1 cancer cell. She literally said it cannot be more than 1 cancer cell left and I will feel confident enough to move on to radiation.

[@yerbba]

With two negative nodes, it is likely that you do not have other positive nodes. That is, a negative denominator is reassuring. Radiation therapy to the axilla is appropriate because of the one positive node, and other microscopic areas, if present, will likely be treated with the radiation therapy. It is hard to find a balance between undertreatment, which no one wants, and overtreatment, which everyone hates! If all 3 nodes had been positive, it is likely that a full dissection would have been done. You may find our video on why we don't do scans after treatment to be helpful: kzbin.info/www/bejne/iZSqcoiEo5KBZ6M

[@thelifeofme3brantley906]

I really needed to hear this because i was just diagnosis With invasive Mammary Carcinoma this past Sept. and my node under the arm is involved so now I understand what that means. Thanks so much..

[@yerbba]

We're so glad the video helped you understand your diagnosis better. Invasive mammary carcinoma with node involvement can be overwhelming, but having clarity makes a difference. Remember, our Yerbba community is here for you every step of the way

[@juanitagee9511]

Thank you Dr. Griggs. This was very informative and has helped me have a better understanding of what's going on. ♡

[@yerbba]

You’re very welcome! We're so glad this video was helpful for you.

[@Rosalicious297]

Thank you once again, Dr Griggs. You mention 7% have distant spread at time of diagnosis, that is, de novo metastasis. Is there a reliable figure for what percentage of women go on to develop metastatic breast cancer overall? I have often seen 30% but presumably that is based on old data when treatment was less effective than now.

[@yerbba]

Great question. The risk of metastatic recurrence varies widely based on the size of the tumor, the number of positive lymph nodes, and the biology of the tumor (hormone receptor status, HER2 status, grade). Treatment also affected the risk of recurrence.

[@miricampos3560]

Hi Dr. I was initially diagnosed with high grade DCIS this august with 6.7 cm area. Had a mastectomy Oct. 3. Pathology showed inasive lymphovascular involvement and 2 lymph nodes had isolated cancer cells, under 200 cells From what Ive been told this doesnt make them positive. Also Her2+. My case was presented to the tumor board as it's "so rare". The board all decided the best treatment is radiation and Her2+ targeted infusions. Don't want chemo, but also scared not to get it. Any thoughts?

[@yerbba]

Nearly all DCIS (90%) is HER2-positive for reasons scientists are not entirely sure of. HER2 status does not play a role in treatment decisions for DCIS. Cells from the DCIS can sometimes get "bumped" during surgery and get trapped by the lymph nodes. If the cancer cells are under the capsule, it is likely they are not metastases but rather there for mechanical reasons. These mechanically displaced cells are not the same as metastases in terms of treatment or prognosis, so taking a look at your pathology report with your team may be helpful.

[@loveintheair-vu8mc]

Your vidoes are indeed very informative and helpful, thank you❤ And thank you for finding time to answer all the questions in the comments

[@yerbba]

Thank you so much for your kind words! We're glad the videos have been helpful to you.

[@juliehunt900]

What is the significance of “extranodal extension”? (Of a sentinel node). Thank you for the straightforward content:)

[@yerbba]

“Extranodal extension” refers to cancer that has spread outside the lymph node into the surrounding tissue. All other things being equal, this finding indicates a slightly higher risk of local recurrence, and radiation therapy is effective in decreasing that risk. Your doctor can provide more context based on your specific case. Also, we're glad you found the content clear and helpful!

[@Fatimanisa-h3f]

My mother is suffering from triple negative serous cancer for 1 year and she is 55 years old. He underwent surgery, 8 cycles of chemotherapy and 20 radiotherapy. Currently he is taking capecitabine 500 pills 4 times a day and he also has diabetes. Now he can eat flax seeds, chia seeds and oats every morning. Do these foods make cancer grow faster? Tell me. Is he suffering from severe back pain and hip joint pain? Have you seen an orthopedic doctor? Gave medicine and calcium When the pain medicine ends, the pain starts again. What to do now. Vitamin B has been taken for a year.

[@yerbba]

The foods your mother is eating, like flax seeds, chia seeds, and oats, are generally considered healthy and shouldn’t make the cancer grow faster. It’s important for her to maintain a balanced diet, especially with diabetes. As for the pain, it’s tough when it returns after the medication ends. Since she’s already seeing an orthopedic doctor, it might be helpful to talk to her oncologist or pain specialist about adjusting her pain management plan.

[@Fatimanisa-h3f]

@yerbba Bone scan test last seven months ago l now can he do bone scan again? Doctor thinks the best cancer can be hip joint cancer? Severe pain in the hip joint. Leg pain can not walk? Severe pain in the hip joint? Dr. my mom to s.creatinine. X-ray lumbosacral Spain both views. X-ray rt hip frog-leg lateral view. crp. x-ray pelvis including both hips Ap view. BMD of spine & Hip. All test results are normal. Now asking for MRI rt hip or bone scan to find the cause of this pain? Which will be good for my mother?

[@lcg2013]

My recent marectomy did not include the lymph nodes. The rationale I use for comfort is that they will be present to alert if the cancer recurrs. What's the typical treatment for phyllodes after surgery?

[@yerbba]

Phyllodes tumors of the breast are rare neoplasms diagnosed through imaging and biopsy. Treatment primarily involves surgical excision with clear margins. Wide local excision suffices for benign tumors, while mastectomy may be necessary for larger or malignant ones. Radiation therapy is sometimes used. Chemotherapy is rarely used. Close follow-up is crucial due to recurrence risk, especially in higher-grade tumors.

[@karenmccarroll6820]

Thank you

[@yerbba]

Thank you for watching!

[@IshankaLakshan-s5y]

Thankyou doctor my daughter have a breasat caser now it is metastatic to lungs she is31 years old and she have 5 years old daughter when she hade biopsy she is in stage 2 she is gioing chemo now can she get wel after chemotherapy

[@yerbba]

Your daughter is fortunate to have you looking out for her, and we wish she were not living with metastatic breast cancer. Chemotherapy can be extremely effective in the treatment of metastatic breast cancer. We are wishing all of you the best.

[@Elenitsa21]

What about lymphovascular invasion? I had a 2.5 mixed mucinous tumor with no lymph node involvement but I had lymphovascular invasion. I had surgery, radiation and have been put on hormone blockers. How worried should I be about lymphovascular invasion? Does it mean that there’s more chance of metastic disease in the future?

[@yerbba]

Lymphovascular invasion sounds similar to lymph node involvement, but it is different. All else being equal, the risk of local recurrence (in the breast) is slightly higher, but with mucinous carcinoma, this is probably not the case.

[@vlogwithsoha2960]

Pls,,mam make video metastatic breast cancer to bone only...Hormone positive breast cancer... Make video of this new treatment and survival rate..pls

[@yerbba]

Thanks for the suggestion.

[@charlenesaldivar5272]

Done my mastectomy last july 22 2024 pregnant 14 week and now im 26 week pregnant my onco advice after my delivery planning my chemo what i can do?

[@yerbba]

It sounds like you’re doing everything you can to protect both yourself and your baby. Your oncologist’s plan to start chemo after delivery is thoughtful, giving you and your little one time to grow. Stay in close touch with your medical team, and lean on them for guidance as you move forward. Also, we actually have a video about pregnancy and breast cancer here [kzbin.info/www/bejne/lXumi5dqjZugp8U].

[@rodelengicaro6999]

I have questions I did 8 cycles of chemotherapy and after mastectomy and axillary dissection the report came out breast is benign but out of 11 lympnodes dissected 3 comes out positive then 15 radio therapy done and now on going capacitabine oral chemo 5 cycle done and with remaining 3 more . How will I know my lympnodes in my axilla will be cured after all the treatment.

[@RoseGarden86]

Thanks dear Dr.Griggs and happy Labor day. My sister's surgeon took out two axillary lymph nodes during her mastectomy. One lymph node came back positive. It was macro (2.4mm) but capsulated. What does capsulated mean? Does it mean it hasn't spread to other nodes ?

[@yerbba]

Happy Labor Day to you as well! Encapsulated means that the cancer was contained within the lymph node and hadn’t broken out into surrounding tissues. It’s a positive sign that it may not have spread further, but your sister’s doctor can give the most accurate interpretation based on her specific situation.

[@RoseGarden86]

@@yerbba Thank you dear Dr.Grighs for always answering questions. God bless

[@iselasotolongo6695]

Thank you for your great explanation. I had a lumpectomy with one lymph node involvement that was removed.. I've always wondered if that means that the cancer can travel thru my lymph nodes to other parts of the body?

[@yerbba]

Thank you for your kind words! We hope this video helped clear things up for you. A positive lymph nodes is associated with a higher risk of recurrence later in life and will often, along with other features (hormone receptor status, HER2 status, tumor size) be used in making treatment recommendations.

[@Aasha271]

Hello Doctor Thanks for maling this useful information also Can you please make a video on Ki67 role in reaccurance irs Many times we are seeing this Word ki67 Thank you

[@yerbba]

Thanks for the suggestion. We will add it to the list!

[@martin.garcia77Mhelz]

Hello i have lumph it was birads 4b last test that was taken last may 18 2024 wid 2.9cm until iam afraid to undergo biopsy as they want to take test again like mamo at it is painful now so i dont take wat can i do pls need advice thank u

[@yerbba]

Hi there, We understand your fear and hesitation, especially with the discomfort you've been experiencing. A BIRADS 4b indicates that further testing, like a biopsy, is recommended to get more clarity. We know the idea of more tests can be overwhelming, but getting accurate information about what's going on is really important for your health. You could talk to your doctor about ways to manage the pain or discomfort during these tests, like using a numbing cream or other options to make it more bearable. It's always okay to ask for what you need to feel more comfortable.

[@martin.garcia77Mhelz]

@yerbba thank u for your concern I am now undergo treatment I also dine biopsy needle now here in Philippines I was diagnosed breast cancer grade 2 now still fighting and probably proceed breast panel at this time

[@bonniemetzger6633]

Hi again, as you may recall I recently had a lumptectomy with stage 1, tubular cancer y clear sentinal node. With trepedation I went on recommended Ameridexand had leg y joint pain plus hair loss over a month. Financial issues have arisen y this month aI couldnt afford the meds on SS alone. I am nervous about stopping the meds for a month. Am I at risk of a return?

[@iconic1758]

Hey why don't you try fenbendazole therapy by Joe tippins?.

[@iconic1758]

?

[@bonniemetzger6633]

@@iconic1758 not ready for experiments. Im following ivermectin but since my case was so early y small, i am preferring to use Amersosas at the moment. Main concern is stopping for a month… Thx will review hm/it.

[@yerbba]

Tubular cancers have a very small risk of recurrence. One month off the medication should not be a problem.

[@bonniemetzger6633]

@@yerbba Thank you. Is it important to continue on with Ameridex even tho the side effects are nearly unbearable.?

[@charlenesaldivar5272]

Invasive carcinoma positive for metastatic tumor cells

[@yerbba]

Invasive carcinoma can sound scary, but you're not alone. We actually have a video about invasive papillary carcinoma here [kzbin.info/www/bejne/sKS7eZxvqbGYe7c]. It explains a lot about how this type of cancer behaves and what to expect.

[@robynkanter9239]

What about lymph nodes in the chest. At what point does that become metastatic?

[@yerbba]

You may be referring to internal mammary lymph nodes. These can be hard to assess. If they are shown to be positive for cancer, treatment is likely to be more extensive in terms of the radiation therapy field. It is usually the case that they will resolve after chemotherapy and radiation therapy. Rarely, cancer can recur in this area.

[@robynkanter9239]

@@yerbba recent diagnosis of positive paratracheal, super clavicle and hilar nodes .. seemed to have jumped from a positive Rotter’s nodes local regional recurrence that was being treated to shrink for surgery. They are now calling it stage 4 but it is still all the chest? No where else. I am being told no surgery. Just wondering where the line is?

[@roselucht4583]

6/9 My lymph nodes were filled with Invasive Lobular carcinoma, it came out of my largest cancer filled node and started spreading out extensively my report said, I had 3rd of 4 chemo sessions yesterday, then on to 30 sessions of radiation.

[@yerbba]

We're sorry to hear about what you’re going through, and it sounds like you’re making great progress with your treatment. You’ve already come so far, and each step is one closer to healing. Wishing you strength as you continue through chemotherapy and radiation.

[@iconic1758]

Anyone else who is following joe tippins deworming protocol?

[@yerbba]

We can't speak for our other viewers. But for those of you interested in this question, fenbendazole is an anthelmintic (anti-worm) medication. There is no evidence at this point that these medications treat breast cancer.

[@iconic1758]

@@yerbba but may have used this to treat cancers of liver prostate lungs.....