Anyone have axillary lymph node dissection AND radiation too?

finallynow

I had a bilateral mastectomy and 1 out of 2 sentinel nodes on one side had a micromet.  So I had an axillary lymph node dissection and no other nodes tested positive.  My surgeon is having me meet with a radiation oncologist to discuss having radiation on that side as well (originally had a 1 cm tumor IDC on that side).  I thought you usually had one or the other, not both, if you had a mastectomy.  Anyone with a mastectomy who had both??  I guess I will find out for sure if I am having both in a few days anyway but want to be mentally prepared!

5kidsMom

My situation has some similarities, but I wanted to encourage you to prepare for rads.  I got my hopes up that I WOULDN'T need rads, and was devastated when I did. 

I had a L MX and my axillary nodes were "clinically positive" by MRI as well as one intramammary node "clinically positive". I had neoajuvant chemo, so by the time they did the SNB of course the nodes were negative (still bitter that I went through that for nothing).  In other words, I never got a positive path report for nodes that had cancer, but by MRI, they looked as if they did, and are being treated as if they did. 

I was told that the need for rads is based on the size of tumor, number of positive nodes, and something else I can't remember lol.  Between now and your appointment, read tons.  It helped me to print out different studies and I brought them to my appt.  My RO read what I brought and explained how the different studies applied to my case.  The bottom line is that each of our cases are different, and just having had a surgery doesn't negate the need (or not) for rads.  Bring someone with you to your appt to help you listen, and don't be afraid to ask tons of questions! 

good luck

ccjj

You may want to look at the thread called Grey zone for radiation or something like that. A lot of us appear to be in this grey area.   I am currently going for my 2nd opinion on whether or not I will need rads. I am hoping not. Good luck with your decision. 

sewingnut

The surgeon said no rads if I had the MX.  The Onc suggested rads due to the 1 positive node.  I had SX first then chemo. Opted not to do rads.  My reasoning is you can only do rads once in any particular area and I would rather play the wait game than expose myself to more radiation. Personally, I think a lot of doctors practice Cover Your A$$ medicine and overtreat.

Kay_G

I had a uni MX and am getting rads, but had a larger tumor than you and like 5kidsMom, positive and palpaple node before sx (had neo adjuvant chemo).  With only a micromet in a node (unless you had neoadjuvant chemo as well), I would think you wouldn't need radiation with a MX.  Talk to your RO and see what he says and get a second opinion if you aren't comfortable.  I do think there are some docs that overtreat, but I certainly wouldn't just dismiss the idea of rads without hearing the reasoning.  Are you young?  Perhaps that is the reason.  Wishing you the best.

finallynow

Yes, I am young so that may be one reason they might decide I should have radiation.  I did not have neoadjuvant chemo.  My surgeon was very surprised when we found out I had a micromet in the sentinel node because he thought there would be no node involvement.  I am fine with having radiation as long as I know the reasoning.  I guess I just didn't realize that after having a mastectomy and an axillary lymph node dissection, that radiation would still be on the table for me.  Oh well, if that's how it's gonna be, then that's how it's gonna be!  Thanks everyone!

dlb823

I also had a mast & rads, which I talked to several rad oncs about and tried very hard to avoid.  But the bottom line was, there were individual characteristics about my dx that made rads prudent, even with a mast.  In my case, those were extracapsular extension in my only positive node, which basically means the bc was already trying to grow out of the node, and who knows if some cells did; and an unspecfied margin on a piece of trimmed tissue that no one, including my BS (which is why it wasn't inked), knew contained a 1mm bit of bc.  Those 2 factors made every rad onc I talked to say that RT would be a wise choice for me.  

Hopefully, you won't need RT, but if it's recommended for you, there are probably specific reasons that can be explained to you, to help you decide the risk/benefit.  My experience doing RT was a piece of cake, and nothing to fear, although I would have preferred not to expose my body to radiation, if I'd felt comfortable skipping it.   Deanna 

mags20487

I too had the bmx..chemo right now and will have rads starting end of January for 30 tx.  I am trip neg with 3 positive nodes so the rad onc said that the radiation would change risk of recurrence from 30% to 7%---good enough for me. 

Maggie

mks16

My situation was very similar to yours... 1 out of 2 sentinel nodes had a micromet, went for further AND and all came back clear. I ended up having radiation recommended to me anyway, because my tumor margins, although clear, weren't as large as the RO wanted them to be. I don't remember the exact margins, but my surgeon told me she felt it was more than sufficient, but RO wasn't comfortable.

I opted for radiation, for peace of mind down the road, although I am fully aware of the potential damage from radiation. As for the actual radiation treatments, they were a breeze for me as well.

Best wishes in deciding what will work for you:)

KatheW

I had MX, alnd, and rads. Like dlb823, I was told the ece (extra capsular extension) in one positive node was the best reason to do rads, although with 3 postitive nodes I already had good reason to do rads. NOt wanting to expose myself to ionizing radiation, I strongly resisted this treatment recommendation, and even found studies to back me up.

After long discussions with my radiation oncologist (who also went through bc treatment), however, I was convinced that radiation is an effective and worthwhile treatment. I just wished I hadn't had the ALND which it seems is NEITHER. Going to rads is not fun, but you will get through it, and feel better fast.

Cat123

I had a left mx and I, too, was devastated to learn that I had to have rads because I really thought I wouldn't need it.  I had 4 nodes positive so the rad onc said that I could have up to a 50% chance of reoccurence if I didn't have it.  Even though I have no breast tissue left, he said it could come back on the chest wall.  So I did it and it wasn't bad.  Good feeling to know that you got every cancer cell lingering in the area.

Patriotic

I just had UMX and AND and am preparing for rads in a few weeks. Not looking forward to it at all but feel it is necessary.

HFArizona

Am curious as to what you decided as I too am facing a similar situation. I suggest you read a Clinical Investigation called " Prognostic Index Score and Clinical Prediction Model of Local Regional Recurrence After Mastectomy in Breast Cancer" . I have had a double mastectomy, and have to have radiation on the left side due to possible mamory node invation, but choose not to have radiation on the right side.

deep2deep

Had neoadjuvant chemo after biopsy + in breast and LN. 18 weeks later, BMX showed complete response (thank God!) and now I do 33rad tx. I am happy to do it to get a little more assurance.