Radiation with Positive Sentinel Nodes?

I'm stage IIb too and had 1 sentinel node positive so they ended up removing 18.  I also had a mastectomy.  I had radiation to the muscles left in my chest wall and to my underarm/axilla area.  A big part of the decision for my breast team to recommend radiation was my age.  They said with 1 node they would not have suggested radiation if I was older, but in my case being young combined with a pretty aggressive cancer they thought I needed it.  I found my radiation onc and his nurse very helpful, so hopefully you will have some questions answered and concerns relieved when you have your radiation consult.  Do your oncologist and radiation oncologist work together?  Mine meet altogether as part of a "breast clinic" so my oncologist had a good idea of what treatment the rad. onc. was going to recommend.

Hi Susan,

I had a BMX (cancer only on the left side), my choice due to family history. 

I fell into the grey area for  radiation.  So far two medical oncologist and my surgical oncologist said that I did not need to radiate my chest wall, but need to discuss with a radiation oncologist whether or not to radiate my axilla because 2/3 sentinel nodes were positive.  So I had another sentinel node and one axilla node negative.  All said if I chose not to radiate the axilla I still had a good prognosis, especially since I will be doing hormone therapy also and my cancer was only 1.3cm

However the radiation oncologist wants to radiate my chest wall too since it is part of their standard of care, which I do not want them to do because it is my left side and I am worried about heart damage, since I am doing chemo with AC + T.

So now my case is going to the tumor board (they all work together at the same cancer center) and I am also going for second opinion.  

I definitely do not want my chest wall radiated, I see no need, had no lymph-vascular invasion, everything was clean in my left breast except for the known DCIS and IDC which we knew about before the surgery.  They only other cancer found were in those two sentinel nodes (which were doing their job and I am grateful for that). 

Even though your onc and rad.onc. are seperate is there a tumor board in your area which you can go to?  I know some universities/cancer centers, etc... provide tumor boards for second opinions on cases, especially if your particular pathology falls into a grey area.  

SAMayoFL

One thing I have learned is to take ONE STEP AT A TIME. When I was going thru chemo...learn and think about chemo. Then I had the MX. After that, then I worked on dealing with the radiation. There is so much information out there that you can overwhelm yourself needlessly. Now I am working on my reconstruction possibilities. It is a process...learn...heal...be well.

Smile_On

Loved your visualization.

BarbaraJo