Sentinel lymph node biopsy: What cancer patients should know

We often hear about lymph nodes when we talk about how cancer spreads. That’s because when cancer starts to spread, it often goes to the lymph nodes first. When treating breast cancer and melanoma, and – increasingly — head and neck cancers and gynecologic cancers, physicians use a diagnostic method called sentinel lymph node biopsy, which looks at a patient’s lymph nodes to determine whether the cancer has spread and what type of cancer treatment is needed. At MD Anderson, our doctors often use sentinel lymph node biopsies because, in many cases, they help better detect cancer. In fact, about 20-30% of “node-negative” patients have disease present in their lymph nodes even though CT scans and/or ultrasound studies suggest that the lymph nodes are negative or do not contain disease. We spoke with head and neck surgeon Stephen Lai, M.D., Ph.D., to learn more.   What is a sentinel lymph node biopsy? Sentinel lymph nodes are an important part of the immune system, and they contain the cells that monitor foreign substances, like bacteria, viruses and cancer. Sentinel lymph node mapping helps to identify the lymph nodes that are at highest risk for containing cancer. A sentinel lymph node biopsy (SLNB) is a surgical approach to identify and remove the sentinel lymph node to determine if the cancer has spread, and if so, how far. In most cases, a negative sentinel lymph node biopsy means the cancer has not spread. A positive biopsy means cancer was found in the lymph node. It could be in other lymph nodes and even other organs. What happens during a sentinel lymph node biopsy?...

Stage III triple-negative breast cancer survivor encourages breast awareness

I never expected to be diagnosed with breast cancer at age 24. So, when I found a mass in my left breast in the summer of 2017, I wasn’t really concerned. I assumed it was a fibroid, and waited until my annual check-up a few months later to ask my gynecologist about it. She thought it was probably a fibroid, too, but she sent me to MD Anderson’s Undiagnosed Breast Clinic to be sure. There, I had a mammogram, followed by an ultrasound. The results showed it was either an infection or breast cancer, so I had a biopsy, too. My doctor called me with the results a few days later. I was out of town at a conference at the time, but I didn’t think she could possibly have bad news. So, when she asked if I was in a good place to talk about it, I answered, “Of course!” That’s when I found out I had invasive ductal carcinoma, a type of breast cancer. My triple-negative breast cancer treatment My heart dropped when I heard the news. I wasn’t even 25 yet, and there was no history of cancer in my family. My doctor said my breast cancer was triple-negative, which meant it didn’t have any genetic markers that could be used for targeted therapy. The cancer was also very aggressive — already at stage III. I needed to start treatment right away. I’d only lived in Houston for about a year at that point, and I always kind of wondered why I ended up there. But after being diagnosed with breast cancer, I think I found...

Breast cancer pathologist: Getting the right diagnosis is crucial

When I first went to medical school, I thought I’d be a cardiologist. My dad was very sick with heart disease while I was growing up, so I spent a lot of time in the hospital. I saw how the cardiologists treated him and other patients, and I wanted to heal people in the same way. But once I actually got to medical school, I found that I was more interested in following pathology specimens to the lab to find out what my patients actually had, rather than in caring for them at their bedsides. I also loved the mental challenge of making a diagnosis, especially in very unusual or difficult cases. Precise treatments based on precise diagnoses All patients who come to MD Anderson will have their diagnoses confirmed by one of our pathologists. We do this first to make sure that their staging is correct, their tumor size is correct and their margin assessment is correct — because all of these factors can affect which treatment options they’re offered. About 25% of our patients will see a change in their diagnosis. That means one out of every four times, a second opinion can be a game-changer. That’s why I believe everyone should get a second opinion, whether they’ve been diagnosed with cancer or not. It doesn’t happen very often that we change someone’s diagnosis from benign to malignant or from malignant to benign, but when we do, it is very significant. Because we offer precise treatments based on precise diagnoses. So, even a slight adjustment can affect, for instance, what treatment options patients are offered first, such...

What I wish I’d done differently during my non-Hodgkin’s lymphoma treatment

When I learned that I had non-Hodgkin's lymphoma in June 2011, an acquaintance said that he knew people who’d received treatment for that disease and still carried on their day-to-day lives without any problems. That made me feel like I couldn’t talk to anyone about what I was going through — which was sometimes really hard! Instead, I put on my best brave face. I didn’t want to be a burden to anyone, especially my family. Today, I am cancer-free, and I have been since 2013. But it’s only in looking back today that I can admit how hard it was. It’s one of the hardest things I’ve ever done. I wish I’d handled it differently. My non-Hodgkin’s lymphoma diagnosis I began experiencing severe stomach pains not long after I turned 30. Eventually, they got so bad that my husband took me to the emergency room. A CT scan showed I had acute appendicitis. I needed surgery immediately. But that wasn’t the only bad news: the ER doctors also said I had enlarged lymph nodes in my abdomen, which can be a sign of lymphoma. They thought that I probably had cancer. My first reaction was shock and disbelief. I was a healthy mom with two very young children. And I had no other symptoms of lymphoma. But as it turned out, the doctors’ suspicions were right. Six weeks after my emergency appendectomy, I had a biopsy. And the results showed I had non-Hodgkin’s follicular lymphoma. Why I’m glad I had appendicitis I’m actually kind of grateful for the appendicitis today, because if it hadn’t been for that trip...

Thyroid cancer survivor: MD Anderson took me from hospice to hope

In January 2017, I was diagnosed with anaplastic thyroid cancer. The disease was so advanced that I was given only a few weeks to live. So, when I first started my battle against cancer, I was just hoping to gain a bit more time. I never dreamed I’d still be here today. Yet here I am, almost two years later. I am completely cancer-free — and I have MD Anderson to thank for it. I knew very little about thyroid cancer or its treatment before I was diagnosed. Even now, most of the medical stuff is over my head. But one thing I do understand is hope. And I found a lot of that at MD Anderson. My anaplastic thyroid cancer symptoms I had a lot of swelling in my neck for several weeks before my diagnosis. I was also unusually tired and irritable. I thought it was just weight gain at first, so I didn’t go to the doctor. But when I started having trouble breathing and swallowing, I went to a local emergency room, near my home in Indiana. The doctors there performed a CT scan, which showed a large mass in my neck, as well as several cancerous lymph nodes. The tumor was so big that it had completely surrounded one of my carotid arteries and almost flattened my windpipe. That made breathing difficult and swallowing even harder. Why I came to MD Anderson The size and location of the tumor made surgery impossible. My local hospital is great and its doctors are talented, but their experience with my type of cancer was extremely limited. They...