Radiation after axillary dissection

I did - Mastectomy & AND in Nov 09, rads in Feb-Mar 10.  In addition to the lump in my breast, I had a lump in my armpit the size of a walnut that was also the breast cancer.  Cancer all gone now.  Am doing great.

Hello Azz,

Yes, I also had the sentinal node positive, and then had full axillary clearance with a total of 30 glands removed, the other 29 were clear, however I then had to have radiation on the axilla.  I do have lymphedema, however I had it before the radiation started.  It was caused by having so many glands removed.  I did have major problems from the radiation with severe burning which bled for many weeks after the radiation treatment had finished. It took many months to heal up, however I am glad I had the radiation,  I was only 52 so I didn't want to take the chance and not have it.  Most people do not react to the radiation the way I did, so don't be afraid of it.  It was far better than the 3 operations I had to endure and was easy.  The worst part for me was that I live 5 hours from the city where I had the radiation, so I had to move away from home for the 6 weeks of treatment, which was hard.

ched

I had level 1 and level 2 axillary node dissection.  3 of 17 lymph nodes were positive and really large.  I was diagnosed with lympedema about a month after my surgery and wear a sleeve and gauntlet.  I have gone through 25 out of 33 radiation treatments which included my whole breast, my clavicle and axilla.  I am red but I have had no fatigue or skin breakdown.  I have had no other side effects and I put lotion on a lot.  My radiologist told me the lymphedema would probably increase about 10% because they were radiating the clavicle area but so far, so good!  Radiation for me was nothing compared to the chemo fatigue I experienced!  I am glad they are being so aggressive because I will do whatever it takes to minimize the chances of this coming back.  Good luck!

Yes, I had the axillary & radiation. Didn't have any problems.....getting rid of the cancer is the first priority. At first I think I was more scared of LE then even of dying, but most people do NOT develop it and it does eventually recede on your 'worry list', and as you can tell by reading the boards, even if one would, there are ways of coping with it. Best of Luck! Ruth

Azz--you had one positive node, and 9 negative ones, as I read your signature.

I work in rad onc, but am not a radiation oncologist--I just hear them talk about planning--I've heard them discuss similar cases and deliberately limit the extent of the radiation to the axilla. It's worth getting a second opinion or a very clear detailed description of the planning--how much radiation to the axilla, and show you the field of radiation.

In my experience, the planning is very operator dependent: they use the planning CT, the doseimitrist (to plot out how to deliver the dose) and the physicist (to also plot out the scatter for safety reasons). Again, I'm not a rad onc, but I did get radiation, and having worked in the field for a couple of years, each case is individuallly planned, in my experience.

Just out of SABC, Andrea Cheville of Mayo Clinic combined SPECT (a gamma CT where radioactive tracer was injected into the arm) with planning CT for radiation and blocked the lymph nodes that drained the arm in the hopes of preventing additional lymphedema--this is brand new stuff.

Here's the link to the Mayo Clinic news release:

http://www.mayoclinic.org/news2010-rst/6084.html

Good luck with this hard decision. I believe you need to get as much information as you need to make this decision. I hate that there's a deadline, and more pressure--not what you need.

Kira

Azz - I had 1 of 15 nodes positive which is a grey area for whether to do rads or not.  I declined them, but only after consults with two different rad oncs and a lot of research.  I found that in my case rads gave me no survival benefits at all, and only a small decrease in loco-regional recurrance.  For me, the risks v. benefits tipped pretty evenly.  Based on QOL issues, I made the decision to decline rads.  

But declining rads is no guarantee of avoiding LE, as I have LE even without doing rads.  Do your research and consult with a couple of different rad oncs, and then make your decision.  Good luck!