To radiate the axilla or not (neoadjuvant)

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 with one more TCH post op. The chemo worked well - no cancer was found in the breast and only 1/9 nodes had some cancer (and only 1 mm). My tumor was ER- and Her2+

Next up is radiation. Because I had chemo before surgery, no one knows exactly how much cancer was in the axilla (or breast) at diagnosis. Different docs are giving me different opinions about what to radiate: the full axilla or not. I don't know who to believe. I don't want rads to the entire axilla, but I don't want a recurrence either. It's a risk/benefit question.

Anyone experience a similar dilemma? Anyone have rads to the entire axilla (armpit)? How did it go? Anyone in the 1% where cancer recurred in the axilla?

Thank you for any input.

Wishing you all peace and blessings,

Diane

fightinhrd123 · May 2010

I had neo too and not cancer left after chemo, (started w 2 pos nodes) so decided to rads anyway. Throw everything at it is the way i look at it. Have 2 friends who also had complete response, they also did rads

marcy4 · May 2010

I have 3/15 nodes positive and have choosen to radiate only the breast and not the auxilla area. My family doctor said it increased my chances of Lympedema. Although my radiation is not until the fall, I have already met with my radialogist and told him what I would do and not do. He was not too thrilled and said he could radiate the auxilla at a lower dose. I still am saying no, but it is a personal decision. I don't know if it is the best thing to do or not, but it is something I feel strongly about. There are lots of ladies who have travelled this path that can give you better advice than I can. Just to clarify, I had my surgery first (lumpectomy, SNB and then auxillary node dissection) and am presently doing chemo.

LJ13-2 · May 2010

My Rad Onc said "because of your age, we wanted to treat you fully." My age being 50 at the time. Treating me fully meant that the field would comprise breast, supraclav nodes, and axilla (positive nodes).

Rads does increase the chances of lymphedema. Lung cancer for smokers and former smokers. Even possible new primary bc.

However, I was determined to fight the cancer I had, not some possible future problem. I did not want to have to deal with the regret of a path not chosen. If I were to recur, it would be only after fighting the bc with every tool I had.

sisterinspirit · May 2010

Diane,

It's always a difficult choice to decide what kind of treatment would be best for you. You are already taking positive steps to find out as much as you can before reaching a decision, so good for you.

As someone who has been dealing with lymphedema as a result of a lumpectomy & SNB, I would strongly encourage anyone considering radiation to the axilla to seek a referral from their onc to a well-qualified lymphedema therapist prior to radiation so that baseline measurements can be taken and you can learn about risk reduction measures you can take to minimize the risk of lymphedema, and to learn what to look out for should you develop lymphedema. Prevention, or in the alternative, early diagnosis and treatment of lymphedema can make a world of difference. Check out the lymphedema thread on these boards and www.stepup-speakout.org website for for information on how to find a well-qualified therapist.

As challenging as lymphedema is, it can be managed. With cancer, I think it's important to fight the best fight possible, taking into account your personal situation and preferences.

Best wishes to you as you go through the maze of treatment options.

To radiate the axilla or not (neoadjuvant)

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