Wednesday 11th - What's an ANC?

I've learnt a lot about how my body works. Just in case you're wondering what some of the terms are, 'axillary node clearance' (ANC) means taking the lymph nodes from under my arm-pit. 'Auxiliary' means 'armpit' in medi-speak.

Why would they do an axillary clearance? They remove the axillary lymph nodes on the side of the cancer, because if the cancer spreads into the lymph nodes, then it can spread more easily around my body - and we don't want that happening at all!

How do they know if it's spread to my lymph nodes? On the day before the operation (that's Thursday/today now), they inject some blue dye into my breast. Mmmm, nice. Then I massage it in and it is allowed to drain into my lymph nodes. It will drain into the 'sentinel' node, or first node it comes across, which tells us where the cancer has gone/would go (IF it has gone there). Then when I'm under, the surgeons remove that sentinel node (called a 'sentinel node biopsy') and they have a look at it to see if the cancer has spread there.

What happens if it is detected in my sentinel node? If it is detected in my sentinel node, they will then do the auxiliary clearance. They will check the sentinel node right away, while I'm under, and then do the auxiliary clearance then and there if they have to. That was the part I had to give my extra consent for yesterday - I hadn't signed for the "+/- (which means 'maybe') axillary clearance" if the sentinel node biopsy is shown to be positive for cancer.

Where is my sentinel node? The dye will drain into my sentinel node, which is probably under my arm pit, but could also be in the centre of my chest or between my neck and my chest. It depends on which way the dye drains as to which bit they remove and test.

What are the chances? Well, we really don't know at this stage, but I really really hope I don't have to have the axillary clearance. Most breast cancers are to the outer part of the breast, closer to the under arm, which means there is a possibility that the lymph nodes have been affected. But mine's on the inner side, closer to the centre of my chest which means two things. One, that the sentinel node might be closer to my sternum (breast bone), not in the usual spot under the arm. And two, that it's slightly less likely that it's spread to the lymph nodes under my arm because of the position. All will be revealed during the operation - and I'll find out when I wake up.

What does it mean to have an axillary clearance? The axillary clearance won't really affect me in the long term. I have enough lymph nodes to keep doing their job, which is a kind of barrier/protection for my body. I might get some nasty swelling (which is why they measured my arm yesterday). One really interesting thing though, is that from now on I have to have all injections, blood pressure tests, blood tests, etc in my right arm, not my left (the left breast is the one being operated on).