Aux nodes clean at mast/CT scan, rad Dr wants aux nodes removed

DL3

Finished TCHP june 17. mastectomy Aug 3. (no cancer in nodes) started radiation Sept 8 Sept 24 the Radiation Dr presented to me that we may want to have my aux nodes removed. Prior to chemo it showed 2 nodes on ultra sound with cancer cells had tchp with 6 treatments then mastectomy and now rads. my rads dr said even tho surgeon found no cancer in nodes nor on CT Scan but because my tumor didnt shrink completely she feels we might want to consider removing the aux nodes. She said that 2 things if this happens ... either they dont have cancer in them and we can celebrate or they did have cancer and we removed them and can celebrate. Her concern is ..even if cant feel the nodes or even if it doesnt show up on ultra sound there could be that teeny microscopic cell left in the node and she wants to get it out if there is. at this time she wants to do an ultra sound on me a month after rads are done to see if the aux nodes show anything... she is thinking it will come back clear. However .....she says even if clear she is mulling over idea of still talking to my surgeon about surgery to remove aux nodes (with my approval of course). A concern...lymphodema and yet another surgery. yet what if I do have that little hidden microscopic cell left in one of those aux nodes. I am seeking your opinions. Thank you

I am ER/PR- and Her2+

DL3

Thank you for the bump Rose! I may post in another topic to see if can get some replies.

Hopeful82014

Are your nodes being radiated? If so, my understanding is that that that should clear up any isolated tumor cells. Guess I just don't follow your radiation oncologist's thinking here, unless she's heavily influenced by your ER- and Her2 status.

I'd say this is something for your MO and surgeon both to discuss with you as well as your RO. Good luck.

DL3

yes nodes are being radiated. Hopeful82014. and after getting home and thinking about the conversation with Rad Dr I figured I better speak with oncologist as well Thank you for your reply

Stephmoen

Did you have a SNB at mastectomy? And did you have a biopsy of the nodes prior to chemo I don't know how they would know for sure they were cancerous if a biopsy was not done

DL3

Stephmoen.... I dont know if had SNB at mastectomy I do know surgeon told my family after surgery and then later to me as well when getting drains removed she saw no cancer in my nodes. and no biopsy of the nodes prior to chemo the only biopsy I had was to the tumor. They are going with that the radiologist saw on my initial ultra sound and mammo that he suspected cancer in the aux. nodes

edit/.... as mentioned my CT scan was clear/clean

ElaineTherese

Hi!

I had a similar situation. Before chemo, I had one lymph node biopsied via fine needle. It tested positive for cancer cells. After chemo, my nodes looked clear on a PET scan and MRI. Nevertheless, RO was adamant about removing all of my first and second level lymph nodes. He said that you treat the original diagnosis, not what your situation looked like after chemo.

When I had 20 lymph nodes removed during my lumpectomy, the pathologist found that they were cancer-free. So, the PET scan and MRI were accurate. However, PET scans and MRIs don't necessarily pick up microscopic cancer cells, so who knows.

Yep, and I had radiation after ALND. Oh well. The good news? No lymphadema (yet). Best wishes!

lkc

hi. None of my nodes showed up on my Pet scan. And 12 out of 14 were positive. 2 were actually extracapsulated. I do know that scan, ct , pets, positive nodes frequently do not show up. In any event I had a full axiallary clearance surgery and no lympedema. I never regretted my decision. I was stage IIIc , er/pr neg and her2 pos.

DL3

Thank you ladies for the replies. I wish the surgeon had taken my nodes out while having mastectomy ... now it means I will have to have another surgery then a reconstruction surgery later. I am glad my radiation dr is on it she and my oncologist are amazing.