I am rather confused. I had a lumpectomy 9 weeks ago and received the biopsy result 3 weeks later via a brief telephone consultation. Margins in the affected breast were clear but cancer was present in one lymph node but with extra capsular spread. I do not remember being told about the extra capsular spread in the telephone conversation but the information was contained in the confirmatory letter received 3 weeks after the telephone call. I had the result of the Oncotype DX test at about the same time. As it was 13/100 I was told I didn't need chemotherapy. An appointment with an oncologist was made for 12 October to discuss treatment options and this would be my first opportunity to speak to a doctor following being told the biopsy result. This would have been 13 weeks after my operation. I contacted my breast care nurse who managed to bring it forward to 16 September (yesterday). In the meantime I read up as much as I could and found research which showed that in cases where only one or two sentinel nodes were positive the removal of all lymph nodes is not seen to be beneficial and treatment can be by radiotherapy alone, and this together with the Oncotype DX test reassured me that I need not worry about the delay is speaking to an oncologist. The oncologist told me yesterday however that when extracapsular spread is present reliance on radiotherapy alone carries additional risk and advised I start hormone therapy immediately (as cells are oestrogen positive) and when I receive radiotherapy the lymph nodes near the throat should also be targeted. I have been fortunate in being offered an early date for axillary clearance and radiotherapy will follow as soon as possible after that. I am obviously concerned that the cancer can already have spread in these 9 weeks and wonder whether chemotherapy should have been considered. Can anyone offer clarity. Thank you.
