Axillary Radiation Therapy

Too-Ticky

Hi. I'm 6 weeks on from my mastectomy and finally (finally!) had my results appointment today. What I've learned is that the combined size of my tumours was 7cm and that's pretty big. One sentinel node was fine but one was diseased. The surgeon would like me to undergo axillary node radiation (in addition to chest wall radiation) rather than have axillary clearance surgery. He quoted the ARAMOS study about it - which I've seem summarised in The Lancet and it seems there is less chance of lymphodema from this treatment than from surgery Which is a positive. But I can't find more information about what to expect, or patient experience or what the negatives are to consider.

Has anybody else had axillary radiation therapy?

What was the experience like?

Have you had side effects? And how are you managing those?

Thanks.

Dani444

Hello, I understand how overwhelming this feels! I had ILC and also ended up with positive nodes, the tumor board also said that radiation would be reasonable rather than having the full axillary clearance. I worried because I went direct to implant but my implant survived and just sits higher than before radiation. They did do chest wall, axillary, sub clavicular, and intermammary nodes. I had 33 treatments. I was sent to a lymphedema therapist prior to rads for measurements and she also gave me stretches to do. She saw me after as well. As far as my skin I did pretty well. I only ended up with one small blister, but just had a lot of swelling and redness. My armpit was the most uncomfortable ( at least the part I could feel). I will say that I was glad to have the stretching guidance as I did feel a lot of tightness in my chest wall muscle during and for a few months following radiation. I finished rads January 2019, my skin is still a patchy reddish/purple in areas but I had a dermatologist tell me that will fade. I do experience some tightness still at times when I am lifting a lot at work and for some reason my armpit feels irritable when I am really hot. It isn’t something that isn’t manageable, just annoying. These decisions are hard and you will make the one this best for you. I wish you all the best as you move forward

Esther01

Thank you Dani, for your experience and encouragement!

Too-Ticky, I would personally recommend the axillary radiation over a wall to wall axillary dissection. Far less risk of lymphedema. My surgeon suggested I consider just the sentinel biopsy, and I had at least two involved nodes. In our prep before surgery, he asked, "Just so I know, what do you want me to do if I get in there during the sentinel biopsy and it looks like you might need a full dissection?" I told him, "No dissection. That's what the radiation will be for. SNLB only." He agreed that made the most sense, based on the same research you read.

Turns out, I had 11 nodes removed (5 involved, 6 clear) and he was thrilled, saying that six clear after the first five had great prognostic value and is confident that he got it all. He still recommends I consider radiation, so here we are. I start 33 rounds on Thursday. I am indeed nervous about the axillary radiation but heartened by personal stories like Dani's from those who have gone through it before us.

In addition, my IMD has threaded several integrative treatment modalities into my radiation protocol. I am all set with creams (including 200mg melatonin cream per the studies that showed it helped reduce radiation burns).

I'm relieved they are allowing me to continue with high dose IV vitamin C (50g) therapy twice a week throughout my radiation. Here is a link to a November 2020 study affirming twice weekly IVC 50g specifically for use during radiation: . https://www.liebertpub.com/doi/10.1089/acm.2020.01...

We all think of Vitamin C as an antioxidant, but at IV levels above 25g, it becomes strongly oxidative and works synergistically with cancer treatments. Those IV C days are my spa days.

Blessings to you as you plan the next phase of your treatment and ultimate recovery!

Esther