2013 Think Pink!: Pathology Results

Assessing lymph nodes (Has cancer spread to the lymph nodes?)

During surgery for invasive breast cancer, some of the lymph nodes in the armpit (axillary nodes) are removed to check for cancer cells. The presence or absence of cancer in these nodes is one of the most important factors affecting cancer stage and prognosis.

Sentinel node biopsy and axillary dissection

To see if cancer has spread to the lymph nodes, most people have a procedure called sentinel node biopsy. During or before this procedure, a radioactive substance (called a tracer) and/or a blue dye is injected into the breast. The surgeon locates the sentinel node(s) by looking for the node that has absorbed the tracer (using a special device called a gamma probe) or the dye (which turns the lymph node(s) blue). The radioactive tracer or blue dye usually identifies one to several (usually fewer than five) nodes as the sentinel nodes. The surgeon removes the sentinel node(s). In removing the sentinel node(s), one or two non-sentinel nodes may also be removed. A pathologist checks the removed node(s) for cancer cells.

If cancer is not found in the sentinel node (the sentinel node is “negative”), it is unlikely that other lymph nodes in the armpit have cancer, and thus no further surgery is needed. If the sentinel node does contain cancer cells (the sentinel node is “positive”), more nodes may be removed with a procedure called axillary dissection. The goal of axillary dissection is to check how many lymph nodes have cancer, which may help determine whether you will have chemotherapy after surgery. It also reduces the chances of cancer returning under the arm.

Axillary dissection removes more tissue than a sentinel node biopsy. Because it disrupts more of the normal tissue in the armpit, axillary dissection is more likely to affect arm function and cause lymphedema. For this reason, sentinel node biopsy is the preferred first step to assessing lymph nodes.

Assessing margins (Was the entire tumor removed during surgery?)

A pathologist checks the tissue removed during surgery. By looking at the tissue under the microscope, the pathologist determines whether the entire tumor was removed and whether the margins (the edges of the tissue removed) are clean. Clean (also called uninvolved or negative) margins mean there is only normal tissue (and no cancer cells) at the edges of the tissue removed from the breast. In these cases, no more surgery is needed. If normal tissue does not completely surround the tumor (called involved or positive margins), more surgery (called re-excision) may be done to get clean margins.

Preserving biopsy tissue

It is standard for hospitals in the United States to preserve and store all biopsy samples as formalin fixed paraffin embedded tissue. When a sample arrives at the pathology lab, it is treated with a substance called formalin, which keeps it from breaking down over time. The treated sample is embedded in a block of paraffin (wax). Later, if you wish to have your biopsy tissue re-examined for a second opinion, or if a new test becomes available that could affect your treatment, the preserved tissue can be obtained from the hospital where the biopsy was done.

PATHOLOGY REPORT

With all this being said, my pathology report came back negative....YES I SAID NEGATIVE. That means I am CANCER FREE!! The 3 lymph nodes taken on the right side are clear, the 3 lymph nodes (2 tissue and 1 sentinal node) taken on the left side (tumor area) are clear and the margins are clear. PRAISE GOD! Thank you to all my prayer warriors! Our prayers have been answered!