Please help me understand!

Hi Christine, you and your mom are at the hardest part of this nasty journey.  Understanding the whole thing.  So confusing.  Positive lymph nodes mean that your mom has evidence of cancer in her lymph nodes, so far, no where else.  With this diagnosis, she still has the very possible expectation of a complete cure.  This is not considered a "spread".  They want to get the lymph nodes that do have cancer out of her.  Then, they will do radiation to "clear up" the area, killing any lingering cancer cells in the location of her tumor.  Then, Arimedex will slow down or interfere with estrogen's ability to "encourage" any new cancer growth.

Two things bad can happen from here.  A local recurrence, which is annoying, but you are no worse off than you were in the first place.  The other thing is metastases, and that is the cancer moving to the bones, brain, lung or liver.  This has not happened yet, the nodes are in our body to stop things from moving on to other organs, your mom's nodes have done this, but they must be removed.  They do not leave positive nodes to sit there and maybe cause trouble.

Now, how do they know what will happen?  They don't.  The providers go with studies that have been going on for 20, 30 years.  They know what the chances are of each of the above two things happening.  So, they try to prevent this by the treatment they have suggested.  Do they know for sure these things will happen if your mom does nothing?  No.  They don't know.  Breast Cancer's ability to be very quirky is well known.  If your mom is in good health otherwise, the node removal surgery is doable, the radiation is doable and the Arimidex should be okay as well.  What they are telling you is the statistics tell your oncologist that, for example, if your mom does nothing her recurrence risk is 15%, with the suggested treatment, it is 5%, then, as far as metastasis, which is eventual death, without further treatment her chances of metastasizing are 25% in 5 years, reduced to say, 8% with the suggested treatment.

Now, these numbers I have stated are just out of my head, I do not know what they actually are.  But ask him.  He will tell you what the numbers actually are, mine were just an example of what they generally look like.

I was 63 at diagnosis, I am 73 now, and just fine.  I had a lumpectomy and radiation.  I worked through the whole thing.  I do not mean to minimize this journey, it can have serious bumps and painful times, but this is your mom's life, and if she is young, she can expect many years of good living with treatment, not as good a chance with just the surgery.

I would get Dr. Susan Love's Breast Book and read just the parts you need.  The later chapters, dealing with advanced cancer, you will not need, and they will scare you.  But this is the way they decide what to do with each individual person.

My mom's best friend died last year at 94, 44 years post double mastectomy.  I met a lady in the dog park who had BC in 1985 and sometimes forgets which side it was on.  Many, many women, in fact about 80% or better of us will recover from this and live out our lives.  But you do need to do what the doctor orders.  You can refuse (your mom) of course, but this is risky.

Other women will be along, we have Beesie who is wonderful with links that will give you more information.  It is just a game of numbers, and since we have advanced so far in treatment, it is foolish not to do what the oncologist suggests.  They are the experts with all the information.

Gentle hugs, Shirlann   

Hi, I would suggest if it is okay with your mom, you go with her on her next doctor appointment so you hear what is suggested for her by her doctor.  If you hear from the doctor you may have a better understanding and be able to ask the doctor the questions you need answered.  As a patient sometimes we hear what we want to hear or do not understand something completely. 

I can relate to not wanting to take a drug after surgery.  I did not want to be reminded every day that I had cancer.  I just wanted to put it behind me.  Give you mom some time to adjust and accept her treatment. 

Also with the age difference with you and your mom, you might have a difference of opinion or how you cope and adjust.  I am 48 and my mom is 73.  Sometimes she does not want to even talk about her health as she has this mind set if she does not talk about it, it will go away.  I am the opposite I want to deal with it right now.  She always come around but we just have a different path to get there.

Good luck with you mom.