Axillary lymph node clearance

Hi, I opted for extra radiotherapy instead of a node clearance. have you been given this option?

i had 3 positive nodes (all visible by eye) that didn’t show up on the ultrasound, consultant said that surgery and rads are equally effective and the choice was left to me, as I have Poland’s syndrome on my right side & the cancer was on my left I didn’t really want both shoulders compromised and wasn’t keen on the much increased risk of lymphedema either! 

I was worried as most people seem to have node clearance but I’m fine with my decision now, I wasn't thrilled at the thought of further surgery after chemo either. 

The radiotherapy was extended to include the armpit and clavicle as well as the breast but was the easiest of all the treatments by far, including the hormone meds. I worked through and drove myself. There were side effects, I was nauseous and very emotional and had upper back ache. However I’m happy with my decision and the fact that my lymph nodes are still there to do the job they are meant to do is reassuring to me. 

Good luck with whatever you decide x

Hi,

I think it depends on the size of cancer found in the lymph nodes, do you know the size? 

Hi Ruthie,

thanks for this...very reassuring.  Having no lymph nodes, Lymphedema and having further issues as I already have back pain and shoulder pain.  My Consultant has recommended removal but will respect my decision.  Thanks so much and keep well x

Hi,

No sorry it doesn’t.  All it says is lymphovascular invasion positive.  Sentinel node biopsy 1/1 lymph node involved (with extra capsular extension). Thanks. 

If there is extra capsular extension the deposit will most likely be bigger than normally recommended for only radiotherapy.  It means that the cancer in the node was pushing out the node itself. I had 1/2 sentinels positive,  and at 6mm it was too large so I had a clearance,  which I obviously didn't want(!) but was pleased about as  I then knew for sure that thr others were clear. 

Will they do it at the same time as the breast surgery?

Hi, yes they’ll do both at same time.   Do you mind me asking if you had any issues after the removal? I will ask my Consultant tomorrow about the size of the cancer in the lymph node.  Thanks 

Hi AliWtem

I am wondering if you only had one lymph node removed, as you say 1/1 positive nodes? Normally they take a few out to see if the cancer has worked its way along any more nodes. Generally, the more positive nodes there are, the stronger the case for a clearance (in addition to whether the cancer has worked its way outside the nodes, and what grade/type it is). I think it is important for you to know that really before deciding whether to go for a full node clearance. For me, pre-surgery ultrasound and MRI scans showed clear nodes. During the mastectomy they took 5 out to test and unfortunately 3 were positive (that was a horrible shock for me). I was then told that the only option was a full node clearance, which was done very speedily (thankfully no more nodes were found to be positive when they did the clearance). I have to admit that post op I had more problems after the clearance than after the mastectomy. Main issues were more pain post surgery and cording which has become quite bad and may be here to stay. I also have more numbness than with the mastectomy. Having said that, given the choice between radio and node clearance, I would opt for the node clearance. Its a personal choice and its your body so I think its a case of gathering all the facts and not being pushed into anything that you are not comfortable with. Good luck and best wishes.

Thank you so much.  Very wise words.  I don’t really feel adequately informed which is why I’m confused. All these responses have helped enormously.  I feel I need further info before I make any decisions.  Thank you again. 

AliWtem you are very welcome. Might be a good plan to write your questions/concerns down ready for when you speak to your consultant. Usually I forget everything that I had planned to ask, so now I always resort to my list of pre-prepared questions! Good luck x

Hi ya,

I had 2 nodes positive...only 2 were removed....i had radiotherapy instead of full clearance owing to the fact that both give the same outcome in prognosis.

Hugs

Lucy B x