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  • CarylC
    CarylC Member Posts: 230
    edited March 2011

    I met with an oncologist for the first time yesterday.  Bi-mx was 2 weeks ago.  I knew I'd be getting chemo, but thought with a mx that I wouldn't need rads.  She's saying a round of chemo, then Herceptin for a year and rads after chemo is over.  Chemo will be TCH or something like that, once a week every 3 weeks but she didn't say for how many rounds and I forgot to ask!  Ugh! 

    My nodes did have extracapular extension but I would think the chemo would kill whatever cancer cells may have escaped from there, so I'm assuming the radiation if for my breast but since it was taken out and I believe I had great margins, I'm surprised.

    Anyone else doing this same route?

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited March 2011

    Carylc - we have a similar diagnosis except for the ER/PR.  I am in the middle of TCHx6 (Taxotere/Carboplatin/Herceptin) but rads is not in my plan.  I had a BMX last Nov.  What area did they mention radiating?

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  • CarylC
    CarylC Member Posts: 230
    edited March 2011

    SpecialK,

    I asked them today how many rounds of chemo, once a week, every three weeks for 6 rounds.  Then asked why radiation, they said because of the nodes, but I didn't ask them where - didn't even think of that question.  They said always rads with nodes.  Is this not common?  These are University of Chicago doctors, who are doing research on HER2 positive cancer, which is why I went there.   

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited March 2011

    My BS who is cutting-edge, Moffitt Cancer Center/ University of South Florida, speaks all over the world, etc. said rads only if I had elected lumpectomy instead of BMX.  My understanding was BMX trumps rads - I have one less node than you but don't know if that makes a difference.  Your age (whether you are in menopause), your margins and tumor size and location and that you are ER-/PR- are also probably factors.  My node involvement was quite small, 20 cell cluster in SN and 6mm in one other node.

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  • CarylC
    CarylC Member Posts: 230
    edited March 2011

    That's what I thought too - I thought I was trading my breasts in exchange for no other treatments!  However, we didn't know at that time that there was nodal involvement, according to the oncologist.  The nodes were "macrometastes" not "micro" (not sure I spelled that right) and I remember them being measured in cm - although I gave my pathology report to oncologist so can't double check.  Also I do know there was extracapsular extension, although I'm not sure that has anything to do with it or not.  I do know that oncologist today said I was very lucky it was only 3 and not 4, because 4 puts you in a whole different ball game.  At this point, I guess it doesn't matter if I do one, two or 3 kinds of treatment, they all suck as far as I'm concerned.  Might as well do it all and make sure I'm safe if I have to do any of them!  The doctors are at the University of Chicago and the lead doctor specializes in HER2+ breast cancer so I'm hopeful they know what they are doing!

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited March 2011

    CarylC - it seems like there are so many tipping points that determine what treatment is appropriate and those treatments don't always go smoothly!  I too was thought to not have nodal involvement during the BMX - BS came to my DH and DD and said nodes were clear.  On post-op path they found the micro in the SN so I had to have another surgery 4 weeks later to do complete axilliary node on the cancer side, with weirdly a larger area than the SN on the one additional node.  I was really on the fence about doing it - thought chemo (which I already knew I was having) would take care of any other problems.  Onc and BS pressed for the removal.  I am now glad I did it but was not happy at the time.  It could very well be that the extent of your 3 positive nodes was enough to drive the rads decision.  One thing I have noticed is that treatment approaches can really vary but it is important to be comfortable with ones choices if possible.  I am sure you and your docs will make the right choices for you, but you're right, it all sucks!

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  • NativeMainer
    NativeMainer Member Posts: 10,462
    edited March 2011

    CarlyC--there are a lot of variables the determine what the "best" treatment option is.  Ask your onc to explain in detail why rads and whatever else is recommended.  You have every right to know exactly why a treatment is recommended and the alternatives, how likely they are to be effective, how effective, and the side effect profile of all the options before making a final choice. 

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