axillary node dissection vs. nodal radiation

kbkea

Has anyone faced a decision of either having complete axillary node dissection vs. doing radiation to the axillary node area?

I had BMX with sentinel node biopsy (6 removed on bad side, 4 on good side) and preliminary test showed all nodes clear, but unfortunately the pathilogy lab found cancer in one of the lymph nodes.

Now my doctor says I need to have complete axillary node dissection and I do not want to do that, due to all the potential side effects.

I have an appointment with Radiologist to see if he can "guarantee" that Radiation will be enough to take care of axilla area.

I wonder if anyone had similar situation, and what decision they have made.

Megadotz

Not exactly the same situation, but a fair amount in common. I had a lumpectomy with five nodes removed, and a micromet in one node found in the final pathology.  This was two years ago, when usually finding this would automatically lead to a full dissection.  The surgeon talked to the medical onc who said the full axillary dissection wasn't necessary since I was going to have radiation anyway and the axillary and super clavical nodes would be added to the treatment.

 I had lympho-vascular invasion as well, and  had chemo of 6xTAC. I think having the radiation instead of the axillary dissection was a good call for me.  There are  no "guarantees" in cancer treatment according to my MO.  There are always tradeoffs. 

 Here's a link from the research news of the main part of the site that talks about the benefit of nodal radiation to prevent reccurance:

http://www.breastcancer.org/treatment/radiation/new_research/20110606.jsp

Good luck in making th decsiosn that is right for you.

coraleliz

I had bilateral tumors. BMX. 2 positive nodes on the left. My MO thought I should have an ALND but my BS & RO disagreed sighting more recent studies. The largest study was done on patients that had lumpectomies with radiation & showed no increased survival in patients that had ALND. Even though I had the more agressive surgery(BMX), this study could be applied to my case. I ended up getting nodal radiation. I was told that my lifetime risk of lymphedema would increase to 30+% with the ALND. I also think that after my BMX, I just didn't care to get anything more cut out.

SKBL

What did you end up doing? I am in the same position of trying to decide whether to have ALND and radiation after one node was positive with a macromet of 7mm. I went to MDA for a second opinion and the onc said radiation should be good enough.  I did not talk to a surgeon there.

Thanks,

Susan