Radiation with Positive Sentinel Nodes?

SAMayoFL

I have 8 weekly treatments of Taxotere to go so I haven't seen the radiology onc. yet.  I was hoping for some feedback from those of you who have already gone through radiation though.  I had four positive nodes but all were sentinel nodes.  All of the axillary nodes were clear.  Has anyone else had only positive sentinel nodes and, if so, was radiation necessary.  Also, it seems important to say that I had a mastectomy.  My tumor was large so a lumpectomy was not an option for me.  I had wide, clear margins after MX.

Thanks for your input!

Susan

Smile_On

I'm stage IIb too and had 1 sentinel node positive so they ended up removing 18.  I also had a mastectomy.  I had radiation to the muscles left in my chest wall and to my underarm/axilla area.  A big part of the decision for my breast team to recommend radiation was my age.  They said with 1 node they would not have suggested radiation if I was older, but in my case being young combined with a pretty aggressive cancer they thought I needed it.  I found my radiation onc and his nurse very helpful, so hopefully you will have some questions answered and concerns relieved when you have your radiation consult.  Do your oncologist and radiation oncologist work together?  Mine meet altogether as part of a "breast clinic" so my oncologist had a good idea of what treatment the rad. onc. was going to recommend.

SAMayoFL

No the oncologist and radiation oncologist are completely separate here.  My onc. won't even schedule my appointment with the radiologist until I have completed 6/12 Taxotere treatments.  Was your postive lymph node your sentinel node as well?  I was 44 at the time of diagnosis so I am older than you but not old, if that makes any sense!  I guess I just need to start wrapping my head around the fact that I will probably end up having to do radiation.  UGH!!!

Thanks for responding!

Susan

ProudMom_Wife

Hi Susan,

I had a BMX (cancer only on the left side), my choice due to family history. 

I fell into the grey area for  radiation.  So far two medical oncologist and my surgical oncologist said that I did not need to radiate my chest wall, but need to discuss with a radiation oncologist whether or not to radiate my axilla because 2/3 sentinel nodes were positive.  So I had another sentinel node and one axilla node negative.  All said if I chose not to radiate the axilla I still had a good prognosis, especially since I will be doing hormone therapy also and my cancer was only 1.3cm

However the radiation oncologist wants to radiate my chest wall too since it is part of their standard of care, which I do not want them to do because it is my left side and I am worried about heart damage, since I am doing chemo with AC + T.

So now my case is going to the tumor board (they all work together at the same cancer center) and I am also going for second opinion.  

I definitely do not want my chest wall radiated, I see no need, had no lymph-vascular invasion, everything was clean in my left breast except for the known DCIS and IDC which we knew about before the surgery.  They only other cancer found were in those two sentinel nodes (which were doing their job and I am grateful for that). 

Even though your onc and rad.onc. are seperate is there a tumor board in your area which you can go to?  I know some universities/cancer centers, etc... provide tumor boards for second opinions on cases, especially if your particular pathology falls into a grey area.  

Smile_On

SAMayFl, 40's are young too.  I might not have thought that a few years ago, but now I definitely believe that.  It's too bad your onc and rad team don't work more closely together.

Yes my positive lymph node was my sentinel node.

Radiation is really not that bad if they suggest it for you.  I really wanted to do anything and everything I could to get any possible cancer out of my body.  It was quite funny, one day at radiation I visualized something like a video game where the radiation was seeking out and exploding any microscopic cancer pieces.

BarbaraJo50

SAMayoFL

One thing I have learned is to take ONE STEP AT A TIME. When I was going thru chemo...learn and think about chemo. Then I had the MX. After that, then I worked on dealing with the radiation. There is so much information out there that you can overwhelm yourself needlessly. Now I am working on my reconstruction possibilities. It is a process...learn...heal...be well.

Smile_On

Loved your visualization.

BarbaraJo

SAMayoFL

Thanks ladies for your replies!  Smile On, I liked your visual as well.  It made me think of playing a Wii game or something and zapping all the bad guys.  I usually am pretty good about taking it one day and one step at a time.  My problem right now is something I am sure we all relate to - a deductible!  I am hoping that I will be able to have reconstruction done by the end of the year since I will meet my deductible this year.  If I have to have 5 - 6 weeks of radiation, which seems to be about what people have, and then 6 months of rest, I will be right up to the end of the year.  My deductible is $1,800 which is a lot of money for me!  I was so hoping someone would say that if all nodes were sentinel nodes and the axilla was clear that radiation might not be necessary.  Oh well, in the end, my health is far more important than money.  I really wish I could have both though!  LOL!!!

Thanks again,

Susan