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Treatment

SD60
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I have Grade 2 IDC and have had a lupectomy 2 weeks ago with a sentinal biopsy which had 1 positive lymph node. I have been told I need to have all the nodes removed after my CT scan results. Then once these nodes have been tested it will determine my next treatment plan. What determines the plan? Does it have to be chemotherapy as I don't want that. What are the alternatives? Also can the surgery be delayed for one month? I am very nervous and worried. I had no issues with the lumpectomy and recovered really quickly. I am ER 8 and HER 2 negative. Not sure if that makes any difference to further treatment. I was hoping just to have radiotherapy and hormone medication for 5 years. I'm really upset that the lymph node was positive and they can't tell without removing all the rest if they are cancerous! Is there any other way of checking without removing?

  • Hi SD60

    Thank you for getting in touch and welcome to the online community. I’m Isobel one of the Cancer Information Nurse Specialist, on the Macmillan Support Line.

    Being told that you are to have further surgery can be very upsetting, it is natural that you are feeling like this.

    As the sentinel lymph node was positive this has indicated that further lymph node surgery is required. The lymph nodes removed will be examined and analysed to determine if there is any further cancer. The results from this will determine the next steps for treatment, along with any other investigations you may have, such as CT scans.

    Treatment for breast cancer that has spread to the lymph nodes may involve chemotherapy and or radiotherapy. It can be difficult to choose the best treatment for you. Your doctor and specialist nurse will explain the different treatment options and help you make a decision. A specialised computer programme called Predict can also help you and your doctor decide which treatment might be best in you. You can speak to your doctor about this.

    The grade of your cancer will also be taken into account, as this will help determine how fast your cancer cells are likely to grow.

    As your cancer is ER 8 this indicates that your cancer is highly receptive to hormones and hormone medication will be offered. This medication will block or reduce the oestrogen that can help your type of cancer grow.

    Your HER 2 negative result will also help determine what treatments can be offered to you, and your specialist will discuss this with you in more detail.

    It is important to talk to your team about your concerns so that they can help address these and talk to you about why any procedures are happening and the correct timing of these. You can ask about alternatives, and these should be discussed with you.

    When more is known about your cancer, you will be able to have more structured conversations about your individual risks, and the concerns that you have. It is very normal at this stage to worry about treatments that you may have, however at the present time your doctors need to gather more information to determine what would be offered.

    It is common to worry about the uncertainties at this stage, talking about this can be very beneficial. Focusing on what you can control right now is one way of managing your worries. It can help you to stop dwelling on future ‘what ifs’. Rather than worrying about things that may never happen, concentrate on what you can influence and do now.

    Please contact us if you would like to discuss this in more detail, on this platform we can only give general information, a two-way conversation can give you the opportunity to talk about your individual concerns, and explore this in more depth.

     

    Best wishes,

    Isobel Y, Cancer Information Nurse Specialist 

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

     

    Ref/ IY/GHi

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