Radiation to the lymph nodes...is it necessary?

Iamloved

My RO is recommending radiation to my lymph nodes even though they were clear after surgery.I am just wondering if this is standard?

moth

It is standard of care after a lumpectomy.

MountainMia

Yes, it's standard. It's part of the local treatment.

fifthyear

Since when did it become a standard to radiate nodes after lumpectomy? Care to share links?

Betrayal

I had a left lower inner quadrant lumpectomy x 2, a negtive sentinel node bx and had whole breast radiation but none to axillary lymph nodes. So it was not standard of care in my experience. I would ask what the rationale is: recurrence? Stage and grade? Hormone presentation?

ShetlandPony

It’s possible there is a lack of clarity in the discussion above. There are three levels of axillary lymph nodes — level I, level II and level III; also called low, mid, and high. (The lowest, level one, are nearest the armpit.) Before I began standard whole breast radiation following lumpectomy, I asked the radiation oncologist if my lymph nodes would be treated. She said level one and some of level two would be in the field. (This may vary by individual anatomy; I do not know.) My point is that some nodes will likely be radiated during whole breast radiation, but part of the treatment plan is how many/what levels, and that depends on the individual diagnosis and evaluation of the nodes.

Beesie

Here are the current NCCN Treatment Guidelines, which suggests consideration of radiation to the nodes for high risk node negative patients.

AliceBastable

When I first met with the RO, he said that I'd get the 22 session basic radiation. Once the post-op pathology showed a micromet in my sentinel node, the plan changed to 33 sessions. I'm assuming that's because the axillary and clavicle areas were now included. The five boosts at the end were concentrated and just to the breast. But I don't know if this is standard.

Iamloved

Beesie...so I assume the reason would be due to my large tumor. I thought after a pCR I would be able to avoid radiating the lymph nodes. I guess not!😟