Question: 1. breast ca late 2010. stage 2a.had bilat/mastec,. 8 nodes removed all negative. had chemo/herceptin. first PET before surgery ok. finished chemo had second PET and ok in july 2011 before tissue expanders were placed
2.Had tissue expanders placed august, a week later ruptured pect muscle and had surgery again on same breast. so 2 surgeries in 1 week
3. after expanders placed,developed healing problems in an area about 1.5 inch along incision, area was bad skin, red/thin and several times had to be restitched and many times oozed clear lymph , no infection and was sent for hyperbaric for 1 month, expanders were umcomfortable,and almost exposed from that poor skin area heavy etc. it never healed as the rest of incision did.
4. last december, finished herceptin and a week later had 3rd PET in preparation for final silicone implants and port removal. PET showed "bilateral implants in place with 1.4 suv right and 1.0 left most likely from inflammation. There is a focus of activity of an isolated lymph node above mastectomy in the axillary region. THIS NODE IS NOT ENLARGED and has 4.5 suv. node is not diagnostic for neoplasm or inflammation in origin". everything else was fine in PET
5.I asked my onco if that node could be cancer and she said no, that it was too early a week after herceptin, and that was caused by all inflammation around the expander and non healing area which was black the day of surgery in january. she said metastatic nodes are usually enlarged. she said as soon as you have your final surgery all these problems will resolve.she was happy and ok final surgery and port removal
6. had final surgery january 11, plastic surgeon found capsule formation around expander which was thickend and red and sent it to pathology and was bening (capsule only) node was not eve mentioned.this was all on the breast that had the cancer.
7.I look back and wonder how was she so sure this node was not BC and went ahead with port out and final surgery. no biopsy or any other test mentioned.my new implants look wonderful, all healed up x 2 months, no soreness or redness and at palpation of axilla, no lumps.plastic surgeon and others agreed with inflammation as the cause for the node. I read node negative rarely recurs just in an isolated node, specially with the obvious problems I had around and the expanders and that being not enlarged argues against mets. this node was not present on 2d PET before the expanders were placed
8.I feel great but this node is worrying me, i'm afraid a biopsy should have been done before final surgery. how can they be so sure and went ahead? is 4.5 too high do you think she was correct? maybe I'm paranoid. she told me it was too hard and will see me in 4 months for bloodwork only and that everything is ok and forget last year . thanks

so you think that it was a reactive node? even with 4.5 suv? i thought it was high, my only concern was that she ok to take port out and do final without biopsy first, but i guess there was obvious cause around it to cause this isolated node, do you think it would have been more suspicious if there had not been inflammation? thanks, you are great