The Sentinel Node Mapping


I can finally type without too much discomfort, after the April 10th surgery, so I am going to begin with the first procedure, just prior to and at surgery.

The sentinel node mapping – the preparation for the sentinel node biopsy- the dye injection – was, for me, the worst of the two days of procedures, including the wire insertion and surgery.

The sentinel node biopsy means the removal of a couple of lymph nodes under the arm, on the side where the breast cancer has been found. It is an exam to find out if the cancer has spread. A radioactive substance is injected into the breast, and then the next day, the surgeon has a marker to help him find the location of the sentinel node and other lymph nodes, for removal.

The nurse navigator (and the brochure I was given) had explained that I must purchase Emla cream at a pharmacy, and apply it to the areola and just outside it, about an hour and a half before the injections would be done. Supposedly, this cream acts as a anesthetic so the procedure of injecting the radioactive dye will not be too painful. Perhaps my husband, who assisted me, did not apply it quite correctly but the results were not good.

The morning before the surgery day, I arrived at the radiology lab at the health center for my appointment, and I was brought to a small room. I changed to a short, upper body only nightie and laid down on a small cot.The radiologist came in with the nurse. She had told me that the injections would hurt, but not too bad. She said the pain was similar to a bee sting. Well, I am a rare one, as at age 59 I’ve never been stung, so I had no idea what might be coming. But I think  she was wrong!

When the first needle was inserted, I could feel it a bit, and I thought, “Oh, not too bad.”  But then came the ‘real’ injection, and oh my. After living through the birth of two children, one of which was about 16 hours, of mostly hard back labor, granted many years ago, I have never in my life had a pain like that. It hurt terribly. Not for long –  I had enough time to think, “Oh my, that really, really hurts. Oh my, I don’t think I can stand it. Oh it hurts. How long is it going to go on? Oh my. I don’t think I can stand it. It really hurts!” And then it stopped. Once more, the same thing. Then it was all over. I would not wish that pain on anyone. If you must have this procedure, be sure to find out how best to apply the Emla cream, if you are using it. If you have an option, of a local anesthetic, by all means, choose it!

I had to return to the radiology lab two hours later, for the scan. This is not pleasant, if you are claustrophobic, but at least it doesn’t hurt. The technician asked me to change to a nightgown, upper body only, and I had to lie down an a narrow cot. She asked if I was claustrophobic, and I told her, “A bit, so I am going to keep my eyes closed for this.” I could feel the bed moving forward, into the scanner area. Then some small whirring sounds. She was nice, explaining how the machine was going to take a picture, “Lie still for one minute” and then, “Lie still for five minutes.” After that, another technician came in, and using the photos just taken, he made marks with a pen on my underarm to show where the lymph nodes were located. This was painless. Then it was all done, and I could go home.

The following day would be the insertion of the wire at yet another health center, and then the surgery. More on that later.