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sentinel nodes?
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sentinel nodes?

› Forums › Cutaneous Melanoma Community › sentinel nodes?

  • Post
    • January 30, 2018 at 1:25 pm
    dessie
    Participant

      You know being in the medical field , it is difficult to know it all .  And this… melanoma,  i do not know enough. Nor do I know how to understand the path report.   

      I had a wide exccison of my sentinel node in my adbomen performed Jan 15, 2018.  I had "lit up" in my right groin as well.   I had my main sentinel dissection done (on my abdomen the wide excision) which happily came back clean and negative.  Two other sentinel nodes that lit up in my groin were also biopsied and 1 of the 2  was "positive for metastatic malignant melanoma with < 5%  of the volume and no extracapusular invasion"

      Question:  how is it the primary sentinel node is negative yet a distant sentinel node is positive?  I have not logically been able to put this together in my head.  (unless the original mole was not the primary)

      I have an appointment today with my surgeon and an hour later with the oncologist so I know myquestions should be answerd.  I also will get the results of my MRI of my brain and my PET scan I had done Friday.

      I have been looking into Mayo Clinic in Jx Fl for (if neded) a minimally invasive lymph node dissection of my right groin.

      If anyone can share their experiences with this procedure please let me know how it went.  

      I will be reporting back this evening as to how things went .

      Until, I will pray that everything will work out for the best and that we all can be healed and find peace in our lives.

      Dessie

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        • January 30, 2018 at 2:19 pm
        ed williams
        Participant

          Hi Dessie, always good to get information on surgery from an expert, so I won't attempt to be one but I have a good link to a presentation from last fall at University of Michigan by an expert on Sentinel node biopsy!!!https://www.youtube.com/watch?v=p_T186r5gIE

            • January 30, 2018 at 5:45 pm
            Janner
            Participant

              Ed also posted a video link about the lymph node dissection recently.  I'd do a search for that before committing to one. 

            • January 30, 2018 at 5:48 pm
            Janner
            Participant

              I haven't watched Ed's video but there can be multiple paths or multiple sentinel nodes.  Some who have had a primary on their back could have both axilas or even a clavicle node light up.  I wouldn't say the groin is "distant" because obviously there is a direct pathway there as well.

              Keep us updated!

              • January 30, 2018 at 7:04 pm
              Bubbles
              Participant

                Ed and Janner shared good info.  Complete lymph node dissection (CLND) and sentinel lymph node biopsy (SLNB) are very different animals.  CLND after a positive SLNB USED to be the standard of care.  But, many things have changed in melanoma care in just the past 5-7 years.  Some folks still opt to do the CLND, but there are many now who do not, and with good reasons.  Here is a link to a recent post I made with an internal link to an in-depth discussion that was had here on MPIP:

                 https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2017/12/sln-biopsy-delay-of-40-days-what-plus.html  

                And while this link is embedded within the text of that post…I will share it here as well…as it gives a history of both the SLNB and CLND and all the reasons for and against:

                 http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2017/07/clnd-complete-lymph-node-dissection-in.html  

                As to the initial question you posed…why one node positive and not the other?  I had a similar outcome in one of my SLNB's.  The bottom line is two fold.  Lymph node duct work and drainage are not as picture perfect in each human as they are in the nice layered diagrams found in text books.  And….sadly, melanoma operates in mysterious ways….mysteries that are being solved daily by researchers, but still without explanation in others.  

                I wish you my best.  Celeste

                  • January 31, 2018 at 1:20 am
                  dessie
                  Participant

                    Tx all for your input.  Negative PET!!  so after disussing with the surgeon and oncologist, I decided to proceed with the CLND as soon as we can and early March start one of two treatments depending on if my blood work comes back + Braf or not .. Another waiting game, but I am now feeling confident about the CLND after reading about both  Invansive vs Non invasive.  . Given my age, longevity in our family and overall good health everyone of the physicians told me to be as aggressive as I can be.  so.  there it is.

                    I thank God that He answered my prayers and that I have some good news and new confidence in my decision about surgery. 

                    Again thanks to everyone here for their concern and input.

                    Dessie

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