Radiation or ALND????? Help!

SKBL

I recently had a prophylactic left breast mastectomy. To our shock, 2 small tumors were found in the breast (3mm and 8mm) and one sentinel lymph node was positive with a 7mm lobular cancer. 4 nodes were taken out total. This cancer was staged 2A.In May 2010, I was diagnosed with a 10 cm lobular cancer and there were micro cells in 2 lymph nodes. I received chemo (TAC), radiation, and am now on tamoxifen. I have received many different opinions as to the course of treatmentfor this new cancer, but I am most concerned about whether or not to have an ALND. The lymph node was considered a macromet. The radiologists think radiation is the answer (and surgery is not needed) and the surgeons think surgery because it is still considered the standard of care. I will not be having chemo because my onc believes it failed the first time, but the plan is to shut down my ovaries and switch me to an AI. I do have lymphedema in the right arm and hate the thought of surgery, but I want to survive! Anyone been in a similar situation? Please post! 

Susan