Axillary Node Dissection after chemo and sentinel node biopsy ?

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DebMo
DebMo Member Posts: 2
edited December 2021 in Older Than 60 Years Old With Breast Cancer

Hello

I am a 65 year old woman. New here :) and in need of community and support during this journey. Feeling isolated and not knowing what to do.

I was diagnosed in June 2021. Stage 1b breast cancer..estrogen and progesterone positive, her2 negative. I had chemo first and recently had a lumpectomy with a sentinel node biopsy. Next should have been radiation, however 3 out of the 5 nodes they removed tested positive for cancer still ..very little cancer in each.

They gave me the option of axillary node dissection to remove more nodes, plus radiation after that.... or I can skip the second node surgery and just do radiation- however there is no data that confirms just radiation is just as good as removing more nodes in my case. There are is a study that was done that was promising.. it just doesnt apply to me because I had chemo first and I have more than 2 positive nodes.

I do not know what to do. I have a big fear of lymphedema should I do the axillary node dissection. I also have a fear that if I skip this and do radiation alone... it will not work. My doctors have said the axillary node dissection could be overkill and the chances of cancer being in other nodes could be slim, but they just cant confirm that or say with certainty.

This is all really new to me and I find every doctor appointment to review tests results and options extremely overwhelming. I want my cancer to go away and not to come back.. I also do not want the side effects of lymphedema. Im just really scared about everything right now.

Does anyone have advice or gone through anything similar?

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  • sunshinegal
    sunshinegal Member Posts: 209
    edited December 2021

    I had to make a similar (though not quite the same) decision about my recurrence. I had already had the sentinal nodes out 11 years ago (all were negative), and the question was whether to do Levels I and II node dissection along with my lumpectomy this round. I really didn't want to deal with lymphedema, and since the nodes looked clear on imaging, I decided to forego dissection and do radiation. I won't know if I made the right decision until I develop mets or lymphedema, or die of something else.

    I do think positive nodes would tilt my thinking, though. Did imaging show possible cancer cells in the sentinal nodes before they were removed?


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  • gb2115
    gb2115 Member Posts: 1,894
    edited December 2021

    I'm sort of in a similar situation, but it's a little different. In 2016 I had lumpectomy and 1 positive node. I then had radiation, no chemo. Fast forward to May, when they found a recurrence. I had mastectomy plus 2 positive nodes. They won't repeat radiation. I had chemo, and am about to have an axillary dissection in January. I'm not happy about it, but I feel like a recurrence is like a big warning sign. We don't know if there's any cancer in more nodes, but imaging never picked up the one node with 5 mm and extranodal extension. I feel like it would be too risky to leave them in, but I'm aware that my risk of lymphedema probably sky rockets, after having already had 2 sentinel node biopsies plus axillary radiation.

    This is all so very very tough...

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  • DebMo
    DebMo Member Posts: 2
    edited December 2021

    Thank you so much for the reply! No, imaging didn't show any cancer cells in the nodes before the sentinel node biopsy which is why I was so disappointed when I received the results. I requested to talk to the surgeon again (I have an appointment next week on Weds) just to ask some additional questions since I was so overwhelmed with information on Monday when I saw her. I know we just all have to make the best decision for ourselves and Im hoping after Weds I have more clarity as to what I want to do.

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  • Murfy
    Murfy Member Posts: 342
    edited December 2021

    DebMo, I'm so sorry you find yourself in this situation. Other members have found themselves in a similar situation and I did find a thread that may be of interest to you (see below). I, myself, had 5 sentinel nodes removed (all negative) that left me with truncal lymphedema, so I can relate to your concerns. I would think the size of your primary tumor and the type of neoadjuvant chemo you received may also play a role in your decision. I would be interested in what you choose to do if you don't mind sharing. Be well...

    https://community.breastcancer.org/forum/145/topic...

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