Lymph removal or radiotherapy- I must choose! Help!

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I had 2 cancerous lumps left breast. ER positive, HER negative.  mastectomy 2 weeks ago. Told today its in 2 lymphs they tested centinel biopsy (on scan it was clear so gutted) and offered either removal now before chemo or radiotherapy after the chemo - I must choose. They can't tell me either/ or as the research shows same outcome with both in my type of cancer. Lymphodema is more of a chance (2/5) with the removal. Im 46. Got over mastectomy really well, jyst a bit of fluid in the cavity to keep a watch. 

I said book in for removal, being done beginning January. Don't know if my decision is right, what is bloomin right in ang of this, but is it a decision that others would make/ have had to make on here? 

  • Hi  

    Fortunately I wasn't presented with any choices while undergoing my treatment for breast cancer last year and it must be incredibly hard when faced with that. The only thing I'd say is that whatever you choose to do was the right choice when you made it. 

    Could you have a chat with your BCN about your options so that you feel totally comfortable with your choice?

    Wishing you a relaxing Christmas and New Year.

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  • I had surgery to remove breast cancer January this year. Cancer found in 2 lymph nodes. February had lymph node removal and out of the 21 removed only 2 was positive. I wasn’t given the option I was told it was getting done. After that I had 8 courses of chemotherapy then 15 sessions of radiotherapy. Last radiotherapy was 10th November. Hopefully now I can go into 2024 feeling more positive that it’s all over 

  • You might want to look at the evidence on the american breast cancer website. I think you have the choice because there is only a very small difference in outcomes between the two options. I had radiotherapy but wish I'd chosen clearance in retrospect. If chemo doesn't resolve cancer in lymph nodes then potentially it could still develop duting the few months of chemo and before radiotherapy. You also get more info about the number of nodes involved. It might make the difference between being offered abemaciclib or not after radiotherapy - maybe ask your team about that one. Id ask specifically what the numbers are for outcomes with radiotherapy vs node removal. Does clearance definitely remove all nodes. What difference would it make if no more affected nodes found vs a couple more found. I think you can go either way here and be right. If you have node removal, would that mean you still have radiotherapy as a future option or as part of your treatment plan. Will they do radiation to the area above your collar bone after chemo? If your gut feeling is to cut it all out and be rid of it now, then do that. You have to be comfortable with your decision in the end. Its so hard to be given options - I had a similar struggle with what was right at the same stage as you. 

  • Thanks for this reply. Im going for removal a week today. Then chemo. No radio as it wasnt near chest wall and if all lymphs removed there will be no radio. You are right the choice was due to no clear difference between outcomes of removal / radio. But I just want it out of me and as you said we'll know the spread better that way. From ultrasound scan it wasnt there, but pathology said it was in nodes, so that was a big knock

    Ninsim Heart