Radiation in armpit

HealthyDiane · May 2010

Hi,

I'm new to this discussion board. I was diagnosed at stage 3. I had chemo (TCH x6) before unilateral mast and more chemo (TCH x1) post surgery. The chemo worked well - no cancer left in the breast and 1/9 nodes were positive. My tumor was ER- and Her2+.

Next up is radiation. Different docs are telling me different things about what body parts to radiate: chest, supraclav (collarbone area), axilla (armpit area). Did anyone have their entire armpit radiated? Anyone have part of it radiated? How are you afterwards - scar tissue, tightness, other things? I know having the axilla (armpit) radiated increases the risk of lymphedema. (so does having the clavicle radiated). Anything I should be asking my docs?

Thank you for any info!

Diane

diana50 · May 2010

hi diane

they can't really predict who will get lymphadema and who won't/ my surgeon was the one who talked to me about it since i had the surgery taking out the nodes. for me; it was just do aggressive treatment so i know i have done all i can to beat cancer....so for me it was "bring on the radiation" .. check out the lymphadema boards; i know people have really taken care of themselves and still ended up with lymphadema. and some ..so far...don't have it . i understand it can show up at any time...so far...i haven't gotten lymphadema.

KerryMac · May 2010

I agree with Diana, I just wanted everything.

I got all 4 areas radiated, I had Rads in June 09, and fingers crossed, so far so good.

gillyone · May 2010

My understanding is if you have positive nodes you will get radiation to axilla and superclavicle area. That is what I got. I had pretty good range of motion after surgery (lump) but found it very tight after rads. But no LE so far and my skin held up really well. I an trying to stretch out my arm several times a day to relieve the tightness. Like Diana I had aggressive treatment - and now feel I've done everything I can.

Colette37 · May 2010

I had all four areas done also...Didn't want radiation and still can't wrap my mind around the fact that something that can GIVE you cancer is also a treatment? Don't get it and probably never will.

I did do the full 33 treatments...How? Lots of Percs (which I don't miss) and Xanax, and looking at my kids. Why? Because it was .01 mm close to my chest wall and all my Dr. (went to 2 different tumor panels) and they all stated it was in my best interest...about 6 or 7 different specialists to boot.

Because I had an idiot surgeon that I started out with and he didn't do the proper lymph node staging BEFORE I started chemo,(wasn't my Oncs fault either, because the surgeon decided he needed to go on vacation the week after on Friday telling me that I had breast cancer and refusing to let me see another surgeon in his practice) they didn't know what my staging was to begin with, and I changed Surgeons by the 3rd chemo tx...the new Surgeon (love Dr. Lee at Swedish) ordered a bone scan along with a PET scan. The bone scan showed a node that they were concerned with under my clavicle, but were unable to test.

My skin after chemo and the radical MX was loose as well as my range of motion. After Rads I have lost some range of motion as well as the skin being very tight and tough.

I am scheduled next Thursday to get a Lat Flap done. I am excited about the prospect but very scared at the same time. I am hoping that it will help with the tightness that I am experiencing.

PM me if you would like.

Binney4 · May 2010

Diane, lymphedema is a risk for all of us who have been treated for breast cancer. The risk increases some with radiation, but there are other factors that influence risk as well (for example, overweight, previous trauma or surgery to the chest, diabetes or other vascular problems, post-surgical infection or seroma or cording). And of course lymphedema is not even in the same class as recurrent bc, so definitely not to be feared.

You should be asking your docs for a referral to a well-trained lymphedema therapist before you begin rads. S/he can take baseline arm measurements for future reference, fit you for a compression sleeve and glove or gauntlet (fingerless glove) to use prophylactically throughout rads (and for exercise and air travel after as well), give you personalized lymphedema risk reduction tips, and teach you a gentle lymph massage to use prophylactically (with modifications during rads until your skin is healed). Here's how to find a well-trained one near you:
http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm

You'll need a referral, and you can get one from ANY member of your medical team, as some don't know much about lymphedema and may be slow to help you with this.

Here's are some simple lymphedema risk reduction ideas:
http://www.stepup-speakout.org/riskreduction_for_lymphedema.htm

Hoping radiation is all smooth sailing for you! Be well,
Binney

krcll · May 2010

Diane- Do they think you had more positive lymph nodes before the chemo? The reason I wonder is that I think I have read that with 3 nodes and under that they don't necessarily radiate the axilla. I could be wrong about that, so I hope someone can come along that knows more about this. On the Stage III thread, most of us have more than 4 positive lymph nodes, so I would expect that most of us have radiated the axilla.

I had 4 fields radiated. I asked my onc if they were zapping the area where the lymph nodes were taken out (my BS said that he had cleaned out well and I didn't need rads there) and he said "no". But they did zap under my arm. I know that there are 3 axillary "levels" and that a normal axillary dissection is from level 1. Maybe they zap levels 2 and 3, in case the buggers made it that far?

I was really worried about LE before I started rads but I decided that, in my case, I just had no choice. LE was better than it coming back. I just had my last rad today (yahoo!!) and so far it has been a total piece of cake. My skin has held up really well (but they say I have been unusually lucky), the scar is just fine and I feel only a tiny bit of tightening of the skin. I am not out of the woods SE-wise until a couple of weeks from now, but I am very optimistic that things will be fine. Of course, LE can come any time, but my arm doesn't feel any worse after rads than before.

It must be very hard for you to be getting conflicting information on what the best treatment is. Good luck on making the decision that is right for you!

janincanada · May 2010

I had radiation in all 4 areas. He gave me the max dose over 16 treatments. I had mast and chemo and herceptin. I did have some reduced range of motion but with exercises, yoga etc. I test at 98% or normal now. That is probably better than before as my shoulders have always been tight.

SpunkyGirl · May 2010

Diane,

Who are these different docs that are giving their opinion about your radiation? The expert on that is a good Radiation Oncologist. He can give you an expert view of what is best for you and why. I too was curious as to why you are getting rads since you only have one positive node. Did you have margins?

I'm over 3.5 out (geez, I'm afraid of jinxing myself), and I haven't had any major issues from rads. I had all four fields radiated. I can tell you that I did everything that Binney advised (God Bless her, she's a saint), and I think that so far it's kept me from having problems with LE.

Whatever you need to do, you can do it!
Love

Bobbie

Radiation in armpit

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