Positive Node after BMX/Neoadjuvant Chemo

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Kodabear1
Kodabear1 Member Posts: 5
edited June 2019 in Surgery - Before, During, and After

I had BMX on 5/29. Four nodes removed and frozen pathology showed all 4 negative. BS did not take out any additional nodes. Fast forward, final pathology showed one node was positive. So, I had a false negative during surgery. BS is bringing to tumor board to discuss next steps. She is leaning against a full axillary dissection even though it is the standard of care. She stated there isn’t a lot of research for those of us who have had neoadjuvant chemo and still have positive nodes post surgery. She thinks radiation will catch any additional rogue cells that may be lurking in nodes. I consult with her radiation oncologist next week and I see my MO this week. My mind is all over the place. Any advice? Anyone else have a similar situation? My treatment team is very experienced and have been practicing at a top teaching hospital in Chicago for decades. However, I still feel conflicted.

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  • Moderators
    Moderators Member Posts: 25,912
    edited June 2019

    Dear Kodabear1,

    Welcome to the BCO community. We are sorry for your diagnosis and glad that you reached out to our members for support and information that could be a help along the way. If you go to the settings tab in the blue tool bar you can learn how to make your diagnosis and treatment information public so that it will show up in your signature line. That can be a help in letting others know a bit more about your diagnosis and situation and hopefully help with more tailored responses. Let us know if we can be of help in your navigation here and finding ways to connect to others to get the help that you need.

    The Mods

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited June 2019

    Hi!

    These days, doctors are recommending radiation to the nodes instead of ALND. So, your BS is following a recent trend. I was treated almost 5 years ago, and ended up with ALND even though both a PET scan and an MRI showed that my nodes were clear after chemo. (One node had tested positive before chemo via a fine-needle biopsy.)

    Surgeons have become increasingly wary of ALND because it increases the patient's chances of lymphadema (as opposed to sentinel node removal). I had 20 of my Levels 1 and 2 axiliary nodes removed and didn't get lymphadema. But, there are plenty of breast cancer patients who are diagnosed with this condition, and you probably don't want to be one of them.

    In fact, I've linked below to a discussion a study showing that ALND and radiation can provide very similar outcomes if a sentinel node tests positive:

    https://www.breastcancer.org/research-news/outcome-same-for-early-bc-tx-w-node-rx-or-sx

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  • Gussy
    Gussy Member Posts: 115
    edited June 2019

    I had two positive nodes after a partial mastectomu after neoadjuvent chemo . I was disappointed with the size of the tumor as well. Chemo really didn't do that much and left me with several permanent side effects. I had an ER+/Pr+Her2 - tumor which I've read sometimes does not respond to chemo. Wish I had known that sooner.

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