ER/PR+, HER2+, one lymphnode involved- 25 years old

Hello Kellif,

Breast cancer is a horrible diagnosis at any age, but especially when young. I'm sorry for your diagnosis. Your questions prompted some of my past actions, so I thought I'd try to answer at least one.

Regarding the radiation for one positive node, there has been no clinical trial done in a random fashion (you get it, you don't) in the 1 to 3 node group of great enough size to reach what is called statistical significance. Hence no one knows whether receiving radiation helps you survive longer when 1 to 3 positive nodes are present with cancer.

However, analysis done on merging data from many of the look back trials on women who received radiation in 1 to 3 positive nodes, suggests a trend (a line towards, a mathematical likelihood) towards greater likelihood of survival when radiation is given. I've posted on this in the past, so if you wish you could use the search feature and type in 1to 3 nodes, radiation. Also, at bc.orgs home site, look under radiation and it summarizes this. Several major cancer centers now recommend radiation to the 1 to 3 node group, where as others review it as an option wo their recommendation per se. 

Radiation has been shown to reduce loco-regional recurrence on the side of the breast cancer by about a third. As to absolute benefit from radiation in preventing distance recurrence, I have seen estimates of percentages from 1 to 2 % up to 6%. The mechanism towards survival trend has been suggest to be one of sterilizing by radiation the chest area of still viable cancer cells, as well as the nodes, so that these viable cells don't harbor as a source of distant seeding through their gaining access to the blood or lymphatic vessels and circulating throughout the body and brain. 

Of late, Dr. Larry Norton has spoken on re-seeding effect of circulating breast cancer cells, as well as seed and soil. Effort to reduce the number of circulating cells in a breast cancer patient may reduce the number of bc cells which travel back to the area originally afflicted and elsewhere. The "soil" refers to the components which make up the background in which the circulating cells may embed, as well as hormones and more which "call" amenable cells to them like a Siren. How radiation changes the original breast tumor site soil will undoubtedly be studied in years hence.

I did have postmastectomy radiation for one node after I read and contemplated many hours over the matter, so perhaps I am too biased. I still wanted to try to explain some of the thought behind this.

Without over-reaching, I am wondering if lumpectomy with radiation was offered to you as an alternative to bilateral mastectomy. Do you have a strong family history or possibly carry the BRCA genes? Obviously our tension is very high with our diagnosis, and some prefer to proceed to full surgery. Support your way what ever your decision, and good speed and recovery to you.

Best,

Tender