Sentinel Node Localisation

Please Take your time with your decision.  I had my mastectomy in April but my recon was cancelled due to covid.  Turns out to have been a blessing as it was all so rushed, and now I have time to really think about about other options.  
Caz x

I agree with the ladies; don’t rush it. It does seem like it needs to be done right now in the initial stage, but afterwards you’ll realise there was no need to rush so much. I’m not saying just relax and forget about the whole thing either 😆, but in the grand scheme of things a few more days (depending on grade and stage of course) won’t make any difference. But the consequences of your choices will be there for years, so really think about it. All the options mentioned by the ladies above are possible. I had a double mastectomy with sentinel node removal, tumours in both breast (because I’m lucky), skin and nipples were spared (left one needs to go though) and expanders put in at the same time. It was done by the one surgeon. They thought I might not need radiation, but it was always a possibility, hence the expanders and not implants. I’ve since changed surgeons, but both of them, including my radiation oncologist, confirmed that having radiation with expanders is not a problem at all. Just make sure to wait at least 6 months after radio to do any recon. 

@Blister I had a bilateral mastectomy (total) in June with expanders inserted by a plastic surgeon. Both my surgeon and PS worked together during the surgery. I had the dye put in while I was in the surgery - I gathered they worked on my good breast while waiting for the dye to track through on the side where the tumour was situated. I had clear nodes which meant I wasn’t going to have radiation. However, my PS was clear before the surgery that he would not do radiation on an expander - that is his decision, there are plenty of women who have radiation with expanders - you should ask how radiation can effect the reconstruction process as you may decide to wait until you know for sure about radiation.

I remember wanting to get everything started, but my medical team and breast care nurse really impressed upon me the fact that I needed to take my time and research what I wanted. They said this is relatively short time - of course stressful and upsetting etc - but they said afterwards, for the years ahead, I needed to be happy with my decisions about reconstruction. My PS - who is amazing - said, ‘You haven’t had a lot of choices so far (regarding BC) but now you get to choose and tell us what you want.’ 

I agree for everything that everyone here has said about the surgery. Please make sure you use the pain relief offered as this will help your recovery. I had 6 days in hospital and went home without drains. The physio will visit you and give you exercises to do and these are essential to start getting your range of movement back - they are very gentle for the start, but so important to do. 

Let me know if I can offer any more advice/support.

@blister - talk with your surgeon and or breast care nurse  to understand what your surgery entails.  I had a total mastectomy and expander inserted in the same operation by my Breast Surgeon.

https://www.bcna.org.au/understanding-breast-cancer/treatment/breast-reconstruction/#expanders

@Blister oh you’re having total. I had skin/nipple sparing. I’m not sure if you can have one put in with a total. But an oncoplastic surgeon would be able to do it if it’s possible. There are a few good ones in Sydney, not sure where you’re from. Just ask around. I know your surgery is already booked but that doesn’t mean you have to go through with it if you can find a better option. 

@FLClover can they do that with a total Mastectomy, my doctor mentioned that I would have to see a plastics guy, but I wouldn’t get in to see him before Christmas, would put everything back a few months, do they do expanders in with a total mastectomy?

@Blister I’m pretty sure someone mentioned this before, but I’ll mention it again. You can have an expander put in at the same time of mastectomy. Expanders are great for radiation and can still in for a long while. That way, if you decide to have recon next year, half the work will already be done and you can avoid extra surgery. If you decide no recon, they’ll just take it out and do a simple mastectomy. 

Thank you @Ecup2020 I have some knitting I’m doing and hoping I will be able to do it post surgery as well.  Yes I will be speaking to the doctor and getting something for pain I can’t take Codeine since I had gall bladder surgery, so hopefully they will have other options.  Unfortunately I won’t be able to go straight into reconstruction as there’s still a big chance of Radiation Therapy was told it’s best to wait till after as the therapy and can affect the area.  Will be having a total mastectomy.  So will look into my reconstruction options next year.

thanks for all your advice and suggestions, hope everything is going well for you

Hi I underwent a mastectomy / stage 1 reconstruction with tissue expander in my left breast 5 weeks ago and had the sentinel node localisation at 11am for surgery in the afternoon list starting at 3.I actually got into surgery closer to 5.
The sentinel node localisation procedure did not hurt at all but I had a lot of pain from the mastectomy / stage 1 reconstruction itself and initial nausea from the intravenous pain meds.
it took me until the second day post op to get that under control and then I improved a lot.
I was discharged home with drains removed ( I had a right breast reduction at same time) 6 days after the op.
My lymph nodes were clear.
Everyone  is different and it’s hard to tell what your reaction will be but from what I understand whether your op is in the public or private system the standard of care is excellent here in Australia.
My own top 6 tips are:
1.Take some good books to read , including for the period when you are waiting for the surgery.
2.Some button down the front pyjamas are good to help you feel more “normal “ after the first couple of days in the very unflattering hospital gown.
3.Be patient with recovery, it will get better each day.
4.Take the proffered pain meds , don’t try to be brave, it’s a big op and you need to keep the pain under control.
5.If you have a breast care nurse take the opportunity to ask them for advice,
mine gave me lots of good advice including where to go for excellent post surgery physiotherapy with a therapist who specialised in post mastectomy patients.
6. Utilise this website and the forum there is a lot of wonderful information here including some specialist groups.

@blister same for me, but luckily only one node on the right side had a micro cancer that was too small and isolated to be considered any kind of threat. Hoping yours is clear too 🤞🤞