Hi,
After 2 lumps were found at routine screening I have had excellent care and had a therapeutic mammoplasty on 26th April. I returned to see surgeon on 11th May and will need a re excision to get clear margins and I have been booked in for on 24th May. It’s more surgery but will be much less invasive than the original op and I consider it to be indicative of a ‘belt and braces’ approach for which I am grateful.
My surgeon also advised me that one of two Sentinel Lymph Nodes she took out is positive with extracapsular spread. There was some discussion about a full lymph node clearance and my initial reaction was that I was reluctant to do this because of the risk of Lymphodema. The surgeon noted this and said that it may be possible to treat with radiotherapy instead. She has since confirmed that this would be possible.
After the re excision I will be referred on to the Oncologist.
Having had a few days to think about it I have lots of questions about full clearance, Lymphodema, radiotherapy to the nodes etc which I would need answered (probably by the Oncologist) before I decide if I would want full node clearance or radiotherapy. My question is, once referred onward to the Oncologist is it possible to go back to the surgeon if I decide that full node clearance is the way I would like to go?
A telephone conversation with a BCN a couple of days ago when she suggested she could arrange for the surgeon to do the full clearance when she does the excision next week has made me concerned that it’s a one time offer only and I have to get it done now before I move on to the Oncologist, problem is, I think it’s the Oncologist I need to speak to to help me decide which way to go on this...
Hi DillysMum welcome to the forum.
The first thing I want to say to you is that surgeons have very different opinions from Oncologists. If as you say the Cancer was found in the lymph nodes the the likelihood is that an Oncologist would offer both Chemo and Radiotherapy for you but would encourage a full node clearance at same time as further surgery.
As far as I am aware there is a path that you follow and you see the Surgeon first then the Oncologist and as I said the Oncologist is the one who will decide if Radiotherapy is required or would work for you if that makes sense. So whilst I accept that the surgeon has said this to you this could change when you get to see the Oncologist and I'm not sure if you would be able to go back or not
What is the risk of Lymphoedema? Sadly there is no way to predict this for you . Sorry not to have been of more help at this time but hope you are able to make the decision that is best for you. xxx .
Hi, I had a multi-disciplinary team (MDT) looking after me throughout my entire diagnosis and treatment. They met every week and discussed my treatment plan together. Your oncologist and surgeon will be speaking to each other, and you can easily decide to have the full node clearance if you want it. I found that both my oncologists and surgeons have been conservative at different times. My surgeon wanted me to have chemo to shrink the lump so that she would get clear margins and my oncologist wanted me to take an earlier surgery appointment so that I wasn't waiting too long between chemo and surgery.
I ended up having 2 surgeons, 2 oncologists and 3 BCNs that I saw and all of them knew everything about my cancer and treatment. Early on, I queried this as it can be alarming turning up expecting to see one person and then seeing someone else, but I was assured that they were interchangeable and acted as a team. I found this to be the case, and I ended up being grateful to have so many people having input to my tailored treatment as every step of the way has been explained to me and where I have had a choice, I was able to talk it through at length with one of the team.
I presume the MDT model is the same everywhere in the UK. It will probably be interesting to hear what the oncologist has to say about node clearance versus radiotherapy/chemo.
Good luck with your decision
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