Re: my mother just diagnosed with breast cancer level 1

Tim Jackson wrote:
> Denise wrote:
> > Pami,
> >
> > Sorry I do have a question afterall, what are positive nodes? Excuse
> > my ignorance.
> >
> >
> Lymph nodes that are found to contain cancer. While they are not
> dangerous of themselves (provided they are removed along with the
> primary tumour), they are an indication of the degree of spread.
>
> Roughly speaking, if there are more than four positive nodes there is
> more than a 50% chance it has spread elsewhere in the body.
>
>
> Tim

Ok, well my mum had the lumpectomy and they've now told her that four
out of the five lymph nodes they removed were positive and that she is
now a Grade 2 and has to have a mastectomy.

What I don't understand is the following and I'd be really grateful if
somebody could advise:-

1. Why did they initially think it was a grade one when they did the
biopsy, what sort of tests do they do on the tissue to determine this
and why is it now all of a sudden a grade two?

2. If they took 5 random nodes and 4 turned out to be positive does
this mean that if they took 20 other random nodes, could those 20 have
been positive?

3. She's not due to start chemotherapy for at least two weeks after
the lumpectomy, istn't there a chance the cancer could spread even
further in that time?

4. If the Cancer now resides in 4 out of 5 lymph nodes what's it's
next most likely port of call, I mean does it spread in like a foot
path of nodes or is it more complex than that?

5. She had a mammogram last June and they gave my mum the all clear,
she believes that the cancer was there then. If they had actually done
a scan as well as a mammogram would the scan have picked it up?

Thanks in Advance. I never expected my mum to get breast cancer as
she has always been so health conscious, she has never smoked, drunk
alcohol and has always been so consiencious about what food she eats.
I also feel very guilty because for the last five years I have suffered
from Depression and I have often talked in the past about wanting to
die because of my depression.


Kind Regards......Denise

Denise wrote:
> Tim Jackson wrote:
>
>>Denise wrote:
>>
>
> Ok, well my mum had the lumpectomy and they've now told her that four
> out of the five lymph nodes they removed were positive and that she is
> now a Grade 2 and has to have a mastectomy.
>
> What I don't understand is the following and I'd be really grateful if
> somebody could advise:-
>
> 1. Why did they initially think it was a grade one when they did the
> biopsy, what sort of tests do they do on the tissue to determine this
> and why is it now all of a sudden a grade two?
>
Grading is not a matter of fact, it is an evaluation of the available
evidence, and it is updated as more evidence becomes available, so it is
not uncommon for the stage to change in the light of the path report,
after that have examined the excised tissue under a microscope.

The mastectomy is I expect not because of the staging, it is because of
the failure to obtain "clean margins".

Her situation most commonly arises when the cancer is found to extend to
the edge of or beyond the excised lump, They normally would try a second
lumpectomy first, unless there is not enough tissue left to warrant
another larger cut, or the cancer is found to be very aggressive.

> 2. If they took 5 random nodes and 4 turned out to be positive does
> this mean that if they took 20 other random nodes, could those 20 have
> been positive?
>
I'm sure they didn't take them at random. It is likely that there were
only five nodes in the lymph path that drains the breast. The number
varies a lot from person to person, maybe anything from 5 to 20 are
common. The number present does not seem to matter very much for
diagnosis, it is the number of positive nodes that is most significant.

> 3. She's not due to start chemotherapy for at least two weeks after
> the lumpectomy, istn't there a chance the cancer could spread even
> further in that time?
>
Insignificantly. Most cancers, at the time of detection, have been
growing for about 10 years, most of that time they were too small to
see. So another couple of weeks isn't likely to make much difference.
Early chemotherapy would also interfere with the wound healing.

> 4. If the Cancer now resides in 4 out of 5 lymph nodes what's it's
> next most likely port of call, I mean does it spread in like a foot
> path of nodes or is it more complex than that?
>
Once it gets past the nodes it passes into the blood. and goes
everywhere, but particularly places where the blood slows down a lot and
there is a suitable environment for the cancer to attach and grow. This
is mainly the long bones and skull, also lungs, liver and brain. The
fact that there is cancer in the nodes means that certainly some has got
into the bloodstream. The big question is whether any have got well
enough established to be beyond the reach of chemotherapy. With four
nodes affected, the chances are about 50/50.


> 5. She had a mammogram last June and they gave my mum the all clear,
> she believes that the cancer was there then. If they had actually done
> a scan as well as a mammogram would the scan have picked it up?
>
The cancer was there then, no doubt at all. It just wasn't showing a
recognisable trace on the mammogram. It happens. Other tools might or
might not have detected it - sonogram or PET scan. PET is good but is
very much a judgement call, it is expensive, it exposes the patient to a
lot of radiation, and it is not available everywhere. So it is not
prescribed lightly, the doctor has to feel there is a good reason to be
looking, otherwise he is likely to create more cancers than he cures.

> Thanks in Advance. I never expected my mum to get breast cancer as
> she has always been so health conscious, she has never smoked, drunk
> alcohol and has always been so consiencious about what food she eats.
>
For all the media hype, diet is not that important. We are not what we
eat, and cancer hits pretty much at random, although some lifestyle
choices increase the risk. Obesity is probably the biggest manageable
risk factor.

> I also feel very guilty because for the last five years I have suffered
> from Depression and I have often talked in the past about wanting to
> die because of my depression.
>
Understandable, but not logical.


Tim Jackson

"Tim Jackson" <tim@tim-jackson.co.uk> wrote in message
news:452e58c9$0$8727$ed2619ec@ptn-nntp-reader02.plus.net...
> Denise wrote:
>> Tim Jackson wrote:
>>
>>>Denise wrote:
>>>
>>
>> Ok, well my mum had the lumpectomy and they've now told her that four
>> out of the five lymph nodes they removed were positive and that she is
>> now a Grade 2 and has to have a mastectomy.
>>
>> What I don't understand is the following and I'd be really grateful if
>> somebody could advise:-
>>
>> 1. Why did they initially think it was a grade one when they did the
>> biopsy, what sort of tests do they do on the tissue to determine this
>> and why is it now all of a sudden a grade two?
>>
> Grading is not a matter of fact, it is an evaluation of the available
> evidence, and it is updated as more evidence becomes available, so it is
> not uncommon for the stage to change in the light of the path report,
> after that have examined the excised tissue under a microscope.
>
> The mastectomy is I expect not because of the staging, it is because of
> the failure to obtain "clean margins".
>
> Her situation most commonly arises when the cancer is found to extend to
> the edge of or beyond the excised lump, They normally would try a second
> lumpectomy first, unless there is not enough tissue left to warrant
> another larger cut, or the cancer is found to be very aggressive.
>
>> 2. If they took 5 random nodes and 4 turned out to be positive does
>> this mean that if they took 20 other random nodes, could those 20 have
>> been positive?
>>
> I'm sure they didn't take them at random. It is likely that there were
> only five nodes in the lymph path that drains the breast. The number
> varies a lot from person to person, maybe anything from 5 to 20 are
> common. The number present does not seem to matter very much for
> diagnosis, it is the number of positive nodes that is most significant.
>
>> 3. She's not due to start chemotherapy for at least two weeks after
>> the lumpectomy, istn't there a chance the cancer could spread even
>> further in that time?
>>
> Insignificantly. Most cancers, at the time of detection, have been
> growing for about 10 years, most of that time they were too small to see.
> So another couple of weeks isn't likely to make much difference. Early
> chemotherapy would also interfere with the wound healing.
>
>> 4. If the Cancer now resides in 4 out of 5 lymph nodes what's it's
>> next most likely port of call, I mean does it spread in like a foot
>> path of nodes or is it more complex than that?
>>
> Once it gets past the nodes it passes into the blood. and goes everywhere,
> but particularly places where the blood slows down a lot and there is a
> suitable environment for the cancer to attach and grow. This is mainly
> the long bones and skull, also lungs, liver and brain. The fact that
> there is cancer in the nodes means that certainly some has got into the
> bloodstream. The big question is whether any have got well enough
> established to be beyond the reach of chemotherapy. With four nodes
> affected, the chances are about 50/50.
>
>
>> 5. She had a mammogram last June and they gave my mum the all clear,
>> she believes that the cancer was there then. If they had actually done
>> a scan as well as a mammogram would the scan have picked it up?
>>
> The cancer was there then, no doubt at all. It just wasn't showing a
> recognisable trace on the mammogram. It happens. Other tools might or
> might not have detected it - sonogram or PET scan. PET is good but is
> very much a judgement call, it is expensive, it exposes the patient to a
> lot of radiation, and it is not available everywhere. So it is not
> prescribed lightly, the doctor has to feel there is a good reason to be
> looking, otherwise he is likely to create more cancers than he cures.
>
>> Thanks in Advance. I never expected my mum to get breast cancer as
>> she has always been so health conscious, she has never smoked, drunk
>> alcohol and has always been so consiencious about what food she eats.
> >
> For all the media hype, diet is not that important. We are not what we
> eat, and cancer hits pretty much at random, although some lifestyle
> choices increase the risk. Obesity is probably the biggest manageable
> risk factor.
>
>> I also feel very guilty because for the last five years I have suffered
>> from Depression and I have often talked in the past about wanting to
>> die because of my depression.
>>
> Understandable, but not logical.
>
>
> Tim Jackson

Tim, you're a marvel! A great asset to the group :-)

Mary

On 12 Oct 2006 05:46:06 -0700, "Denise" <denise528@hotmail.com> wrote:

>I never expected my mum to get breast cancer as
>she has always been so health conscious, she has never smoked, drunk
>alcohol and has always been so consiencious about what food she eats.

Many many people get cancer who have always led healthy lives. It isn't
about anything she did or didn't do.

>I also feel very guilty because for the last five years I have suffered
>from Depression and I have often talked in the past about wanting to
>die because of my depression.

Don't beat yourself up, depression is a real illness and makes people
think irrational thoughts. You *didn't* kill yourself and now you're
able to be there to be a loving support for your Mum.

My son was in exactly the same position as you, but he has been my rock
during the past year after I had my mastectomy, and suffered what seemed
like an endless seroma followed by a long-running abscess and finally
chemotherapy.

Since his illness prevents him working, he did all the shopping, all the
cooking and all the housework, and when I was still in bed for most of
the day, he kept popping in to see me to make sure I was OK, usually
bringing a cup of tea or some other little treat.

And strange as it may seem, I'm almost sure that my illness has been
partly instrumental in making him feel very much better. I couldn't say
why, though. Maybe it was because he felt of use.

I'm thinking about you both. Your Mum will probably have many years of
happy life ahead of her, so don't despair just yet. I know it's hard
when you're depressed, but lots of people live for years and years after
diagnosis.

x{yz}enophil44@hotmail.com wrote:
> On 12 Oct 2006 05:46:06 -0700, "Denise" <denise528@hotmail.com> wrote:
>
> >I never expected my mum to get breast cancer as
> >she has always been so health conscious, she has never smoked, drunk
> >alcohol and has always been so consiencious about what food she eats.
>
> Many many people get cancer who have always led healthy lives. It isn't
> about anything she did or didn't do.
>
> >I also feel very guilty because for the last five years I have suffered
> >from Depression and I have often talked in the past about wanting to
> >die because of my depression.
>
> Don't beat yourself up, depression is a real illness and makes people
> think irrational thoughts. You *didn't* kill yourself and now you're
> able to be there to be a loving support for your Mum.
>
> My son was in exactly the same position as you, but he has been my rock
> during the past year after I had my mastectomy, and suffered what seemed
> like an endless seroma followed by a long-running abscess and finally
> chemotherapy.
>
> Since his illness prevents him working, he did all the shopping, all the
> cooking and all the housework, and when I was still in bed for most of
> the day, he kept popping in to see me to make sure I was OK, usually
> bringing a cup of tea or some other little treat.
>
> And strange as it may seem, I'm almost sure that my illness has been
> partly instrumental in making him feel very much better. I couldn't say
> why, though. Maybe it was because he felt of use.
>
> I'm thinking about you both. Your Mum will probably have many years of
> happy life ahead of her, so don't despair just yet. I know it's hard
> when you're depressed, but lots of people live for years and years after
> diagnosis.

Thanks for your response, that's very reassuring. I hope you are
better, are you?

Denise

Tim,

Thanks so much for explaining. I still don't understand the path the
cancer takes through the lymph nodes though. Does the cancer have to
spread through all the lymph nodes before it reaches the blood stream?
If a person had 20 lymph nodes then does the cancer have to spread
through all 20 before it reaches the blood stream or does it only need
to be in one of them?

Forgive my ignorance, I did speak to the Nurse and she advised me that
the lymph nodes were sort of grouped in an upside down triangle where
level one was at the bottom of the triangle and level two and three
were at the top. I understand that my mum had lymph nodes at level one
and two, not sure what or where the level three nodes are though, are
these in the neck? Do all lymph nodes in level 1, 2 and 3 have to be
affected before the cancer travels to the blood stream?


Denise

I know
Tim Jackson wrote:
> Denise wrote:
> > Tim Jackson wrote:
> >
> >>Denise wrote:
> >>
> >
> > Ok, well my mum had the lumpectomy and they've now told her that four
> > out of the five lymph nodes they removed were positive and that she is
> > now a Grade 2 and has to have a mastectomy.
> >
> > What I don't understand is the following and I'd be really grateful if
> > somebody could advise:-
> >
> > 1. Why did they initially think it was a grade one when they did the
> > biopsy, what sort of tests do they do on the tissue to determine this
> > and why is it now all of a sudden a grade two?
> >
> Grading is not a matter of fact, it is an evaluation of the available
> evidence, and it is updated as more evidence becomes available, so it is
> not uncommon for the stage to change in the light of the path report,
> after that have examined the excised tissue under a microscope.
>
> The mastectomy is I expect not because of the staging, it is because of
> the failure to obtain "clean margins".
>
> Her situation most commonly arises when the cancer is found to extend to
> the edge of or beyond the excised lump, They normally would try a second
> lumpectomy first, unless there is not enough tissue left to warrant
> another larger cut, or the cancer is found to be very aggressive.
>
> > 2. If they took 5 random nodes and 4 turned out to be positive does
> > this mean that if they took 20 other random nodes, could those 20 have
> > been positive?
> >
> I'm sure they didn't take them at random. It is likely that there were
> only five nodes in the lymph path that drains the breast. The number
> varies a lot from person to person, maybe anything from 5 to 20 are
> common. The number present does not seem to matter very much for
> diagnosis, it is the number of positive nodes that is most significant.
>
> > 3. She's not due to start chemotherapy for at least two weeks after
> > the lumpectomy, istn't there a chance the cancer could spread even
> > further in that time?
> >
> Insignificantly. Most cancers, at the time of detection, have been
> growing for about 10 years, most of that time they were too small to
> see. So another couple of weeks isn't likely to make much difference.
> Early chemotherapy would also interfere with the wound healing.
>
> > 4. If the Cancer now resides in 4 out of 5 lymph nodes what's it's
> > next most likely port of call, I mean does it spread in like a foot
> > path of nodes or is it more complex than that?
> >
> Once it gets past the nodes it passes into the blood. and goes
> everywhere, but particularly places where the blood slows down a lot and
> there is a suitable environment for the cancer to attach and grow. This
> is mainly the long bones and skull, also lungs, liver and brain. The
> fact that there is cancer in the nodes means that certainly some has got
> into the bloodstream. The big question is whether any have got well
> enough established to be beyond the reach of chemotherapy. With four
> nodes affected, the chances are about 50/50.
>
>
> > 5. She had a mammogram last June and they gave my mum the all clear,
> > she believes that the cancer was there then. If they had actually done
> > a scan as well as a mammogram would the scan have picked it up?
> >
> The cancer was there then, no doubt at all. It just wasn't showing a
> recognisable trace on the mammogram. It happens. Other tools might or
> might not have detected it - sonogram or PET scan. PET is good but is
> very much a judgement call, it is expensive, it exposes the patient to a
> lot of radiation, and it is not available everywhere. So it is not
> prescribed lightly, the doctor has to feel there is a good reason to be
> looking, otherwise he is likely to create more cancers than he cures.
>
> > Thanks in Advance. I never expected my mum to get breast cancer as
> > she has always been so health conscious, she has never smoked, drunk
> > alcohol and has always been so consiencious about what food she eats.
> >
> For all the media hype, diet is not that important. We are not what we
> eat, and cancer hits pretty much at random, although some lifestyle
> choices increase the risk. Obesity is probably the biggest manageable
> risk factor.
>
> > I also feel very guilty because for the last five years I have suffered
> > from Depression and I have often talked in the past about wanting to
> > die because of my depression.
> >
> Understandable, but not logical.
>
>
> Tim Jackson

On 13 Oct 2006 05:34:31 -0700, "Denise" <denise528@hotmail.com> wrote:

>Thanks for your response, that's very reassuring. I hope you are
>better, are you?

I am, thank you. I still tire easily, but apparently that's within the
"normal" range.

Denise wrote:
> Tim,
>
> Thanks so much for explaining. I still don't understand the path the
> cancer takes through the lymph nodes though. Does the cancer have to
> spread through all the lymph nodes before it reaches the blood stream?
> If a person had 20 lymph nodes then does the cancer have to spread
> through all 20 before it reaches the blood stream or does it only need
> to be in one of them?
>
No. Think of the lymph node as an inefficient filter. It is mainly a
place where the lymph slows down and takes a tortuous path so that the
immune system has time and space to work on whatever is in the lymph.
It isn't like a kidney which stops everything over a certain molecular
size. So the cancer cells do pass through it. But it is a good place
for cancer cells to attach and grow, and a percentage do. So the fact
that there is cancer there is a witness pointing and saying "He went
that-a-way!".

>
> Forgive my ignorance, I did speak to the Nurse and she advised me that
> the lymph nodes were sort of grouped in an upside down triangle where
> level one was at the bottom of the triangle and level two and three
> were at the top. I understand that my mum had lymph nodes at level one
> and two, not sure what or where the level three nodes are though, are
> these in the neck? Do all lymph nodes in level 1, 2 and 3 have to be
> affected before the cancer travels to the blood stream?
>
I think she is only talking about the nodes in the axilla (armpit) which
are the main (but not only) drain for the breast. The supraclavicular
ones I think do not carry breast lymph. The lymph travels through most
of the levels to get to the blood. The first ones get infected first,
so if the topmost level or two are clean, there is no need to remove the
rest, and no need to lose their function.
However if any are infected, then it is normal to remove all of them, an
axillary clearance, as there may well be as yet undetectable microscopic
cancers in the downstream levels.


Tim

Only one positive node can spread cancer. The trouble is sometimes people
have all positive nodes and never have spread while one node and you can
have spread. But the chances are more positive nodes increase the chance of
spread.

Alex

"Denise" <denise528@hotmail.com> wrote in message
news:1160743335.052283.312820@m7g2000cwm.googlegro ups.com...
> Tim,
>
> Thanks so much for explaining. I still don't understand the path the
> cancer takes through the lymph nodes though. Does the cancer have to
> spread through all the lymph nodes before it reaches the blood stream?
> If a person had 20 lymph nodes then does the cancer have to spread
> through all 20 before it reaches the blood stream or does it only need
> to be in one of them?
>
> Forgive my ignorance, I did speak to the Nurse and she advised me that
> the lymph nodes were sort of grouped in an upside down triangle where
> level one was at the bottom of the triangle and level two and three
> were at the top. I understand that my mum had lymph nodes at level one
> and two, not sure what or where the level three nodes are though, are
> these in the neck? Do all lymph nodes in level 1, 2 and 3 have to be
> affected before the cancer travels to the blood stream?
>
>
> Denise
>
> I know
> Tim Jackson wrote:
>> Denise wrote:
>> > Tim Jackson wrote:
>> >
>> >>Denise wrote:
>> >>
>> >
>> > Ok, well my mum had the lumpectomy and they've now told her that four
>> > out of the five lymph nodes they removed were positive and that she is
>> > now a Grade 2 and has to have a mastectomy.
>> >
>> > What I don't understand is the following and I'd be really grateful if
>> > somebody could advise:-
>> >
>> > 1. Why did they initially think it was a grade one when they did the
>> > biopsy, what sort of tests do they do on the tissue to determine this
>> > and why is it now all of a sudden a grade two?
>> >
>> Grading is not a matter of fact, it is an evaluation of the available
>> evidence, and it is updated as more evidence becomes available, so it is
>> not uncommon for the stage to change in the light of the path report,
>> after that have examined the excised tissue under a microscope.
>>
>> The mastectomy is I expect not because of the staging, it is because of
>> the failure to obtain "clean margins".
>>
>> Her situation most commonly arises when the cancer is found to extend to
>> the edge of or beyond the excised lump, They normally would try a second
>> lumpectomy first, unless there is not enough tissue left to warrant
>> another larger cut, or the cancer is found to be very aggressive.
>>
>> > 2. If they took 5 random nodes and 4 turned out to be positive does
>> > this mean that if they took 20 other random nodes, could those 20 have
>> > been positive?
>> >
>> I'm sure they didn't take them at random. It is likely that there were
>> only five nodes in the lymph path that drains the breast. The number
>> varies a lot from person to person, maybe anything from 5 to 20 are
>> common. The number present does not seem to matter very much for
>> diagnosis, it is the number of positive nodes that is most significant.
>>
>> > 3. She's not due to start chemotherapy for at least two weeks after
>> > the lumpectomy, istn't there a chance the cancer could spread even
>> > further in that time?
>> >
>> Insignificantly. Most cancers, at the time of detection, have been
>> growing for about 10 years, most of that time they were too small to
>> see. So another couple of weeks isn't likely to make much difference.
>> Early chemotherapy would also interfere with the wound healing.
>>
>> > 4. If the Cancer now resides in 4 out of 5 lymph nodes what's it's
>> > next most likely port of call, I mean does it spread in like a foot
>> > path of nodes or is it more complex than that?
>> >
>> Once it gets past the nodes it passes into the blood. and goes
>> everywhere, but particularly places where the blood slows down a lot and
>> there is a suitable environment for the cancer to attach and grow. This
>> is mainly the long bones and skull, also lungs, liver and brain. The
>> fact that there is cancer in the nodes means that certainly some has got
>> into the bloodstream. The big question is whether any have got well
>> enough established to be beyond the reach of chemotherapy. With four
>> nodes affected, the chances are about 50/50.
>>
>>
>> > 5. She had a mammogram last June and they gave my mum the all clear,
>> > she believes that the cancer was there then. If they had actually done
>> > a scan as well as a mammogram would the scan have picked it up?
>> >
>> The cancer was there then, no doubt at all. It just wasn't showing a
>> recognisable trace on the mammogram. It happens. Other tools might or
>> might not have detected it - sonogram or PET scan. PET is good but is
>> very much a judgement call, it is expensive, it exposes the patient to a
>> lot of radiation, and it is not available everywhere. So it is not
>> prescribed lightly, the doctor has to feel there is a good reason to be
>> looking, otherwise he is likely to create more cancers than he cures.
>>
>> > Thanks in Advance. I never expected my mum to get breast cancer as
>> > she has always been so health conscious, she has never smoked, drunk
>> > alcohol and has always been so consiencious about what food she eats.
>> >
>> For all the media hype, diet is not that important. We are not what we
>> eat, and cancer hits pretty much at random, although some lifestyle
>> choices increase the risk. Obesity is probably the biggest manageable
>> risk factor.
>>
>> > I also feel very guilty because for the last five years I have suffered
>> > from Depression and I have often talked in the past about wanting to
>> > die because of my depression.
>> >
>> Understandable, but not logical.
>>
>>
>> Tim Jackson
>

My late wife had NO positive lymph nodes, yet her BC metastasized
to her liver and bones..

--
John Richards


"alex" <alex@noemail.com> wrote in message news:ROKdnTuPxeWEjq3YnZ2dnUVZ_omdnZ2d@comcast.com. ..
> Only one positive node can spread cancer. The trouble is sometimes people
> have all positive nodes and never have spread while one node and you can
> have spread. But the chances are more positive nodes increase the chance of
> spread.

On Fri, 13 Oct 2006 23:58:44 GMT, "John Richards"
<jr70@blackhole.invalid> wrote:

>My late wife had NO positive lymph nodes, yet her BC metastasized
>to her liver and bones..

I had no positive nodes, but I opted for chemotherapy anyway, because I
knew other people this had happened to.

<x{yz}enophil44@hotmail.com> wrote in message news:jch1j29abgq1sp3b20l8lhvsphogng12uh@4ax.com...
> On Fri, 13 Oct 2006 23:58:44 GMT, "John Richards"
> <jr70@blackhole.invalid> wrote:
>
>>My late wife had NO positive lymph nodes, yet her BC metastasized
>>to her liver and bones..
>
> I had no positive nodes, but I opted for chemotherapy anyway, because I
> knew other people this had happened to.

Yep. One cannot assume that lymph nodes are the only path by which
breast cancer can spread elsewhere in the body.

--
John Richards

John Richards wrote:
> <x{yz}enophil44@hotmail.com> wrote in message
> news:jch1j29abgq1sp3b20l8lhvsphogng12uh@4ax.com...
>
>> On Fri, 13 Oct 2006 23:58:44 GMT, "John Richards"
>> <jr70@blackhole.invalid> wrote:
>>
>>> My late wife had NO positive lymph nodes, yet her BC metastasized
>>> to her liver and bones..
>>
>>
>> I had no positive nodes, but I opted for chemotherapy anyway, because I
>> knew other people this had happened to.
>
>
> Yep. One cannot assume that lymph nodes are the only path by which
> breast cancer can spread elsewhere in the body.
>
I believe there are also usually lymph paths to the other breast and to
the liver which do not pass through the axilla. So it is possible
although uncommon that a tumour has shed cells into one of these ducts
without affecting any axillary ducts. It's also possible for a tumour
to have invaded a vein and shed directly into the bloodstream, although
lymph ducts are much easier to get into, and metastasising tumours are
quite big on the scale of capillaries, so are bound to capture some of each.

Tim

Tim,

Thanks again for taking the time to explain all of this to me in such
detail. I did do Biology at school but I don't remember reading much
about the lymph nodes. I'm concerned about my mum at the moment
because she keeps getting a fever and she is hoping to start chemo next
Tuesday. Unfortunately if this fever doesn't go then she won't be able
to start it.

So fingers crossed whatever is causing her high temperature will go
over the next few days, although they can't find any infection anywhere
so don't really know what's causing her to have a high temperature.


Denise
Tim Jackson wrote:
> Denise wrote:
> > Tim,
> >
> > Thanks so much for explaining. I still don't understand the path the
> > cancer takes through the lymph nodes though. Does the cancer have to
> > spread through all the lymph nodes before it reaches the blood stream?
> > If a person had 20 lymph nodes then does the cancer have to spread
> > through all 20 before it reaches the blood stream or does it only need
> > to be in one of them?
> >
> No. Think of the lymph node as an inefficient filter. It is mainly a
> place where the lymph slows down and takes a tortuous path so that the
> immune system has time and space to work on whatever is in the lymph.
> It isn't like a kidney which stops everything over a certain molecular
> size. So the cancer cells do pass through it. But it is a good place
> for cancer cells to attach and grow, and a percentage do. So the fact
> that there is cancer there is a witness pointing and saying "He went
> that-a-way!".
>
> >
> > Forgive my ignorance, I did speak to the Nurse and she advised me that
> > the lymph nodes were sort of grouped in an upside down triangle where
> > level one was at the bottom of the triangle and level two and three
> > were at the top. I understand that my mum had lymph nodes at level one
> > and two, not sure what or where the level three nodes are though, are
> > these in the neck? Do all lymph nodes in level 1, 2 and 3 have to be
> > affected before the cancer travels to the blood stream?
> >
> I think she is only talking about the nodes in the axilla (armpit) which
> are the main (but not only) drain for the breast. The supraclavicular
> ones I think do not carry breast lymph. The lymph travels through most
> of the levels to get to the blood. The first ones get infected first,
> so if the topmost level or two are clean, there is no need to remove the
> rest, and no need to lose their function.
> However if any are infected, then it is normal to remove all of them, an
> axillary clearance, as there may well be as yet undetectable microscopic
> cancers in the downstream levels.
>
>
> Tim