Your advice pls - get rid off lymph nodes or radiotherapy?

Hi smallphooh,

I don’t know if this is the best option so please research further. I had 2 lymph nodes with macro metastasis and a grade 3 discovered at lumpectomy Feb 23. I asked my surgeon what she would do in my position and she said she would have a total node clearance as it would give more information. At that point I didn’t understand my breast cancer and all its variables such as Er, Pr and Her2 status but she obviously did and I took her advice. Luckily I had no further node involvement, I have found the clearance more problematic than the lumpectomy only in that I developed cording but overcome that with exercise but so far I haven’t developed lymphoedema. I was able to have a lumpectomy 10 after I received my results I think I would have had to wait several weeks for radiation to my lymph node’s although I didn’t factor that into my decision, I just put my trust into the surgeons knowledge and experience as I knew she was acting in what she believed was my best interest. I don’t regret my decision. 

I feel the same as shade. I did not have all my nodes removed, and now wish I had. I would ask how effective radio is at destroying all cancer in lymph nodes when compared with surgery. The extra info about how many nodes involved can be useful. The risk I was told about was the higher risk of lymphoedema and cording with clearance. Restricted shoulder movement can delay any radio needed, so v important to do the exercises regularly and for some months afterwards. Cancer was my dominant arm side, so decided against clearance at the time. Wish I had the certainty now of having all the cancer surgically removed. 

I think the significant thing may be that your cancer is grade 1, not 2 or 3, meaning it’s not aggressive. Maybe ask the surgeon why they are making their recommendation and look into the lymphoedema risk of the 2 options? 

I was given the same choice. Grade 2 Er+ve  had mastectomy and SNB 2 of 3 nodes with ‘cells”. Clinically normal on US and during surgery. Offered clearance or radiotherapy- surgeon believed both offer same outcome but radiotherapy less potential for lymphoedema. I was also offered chemotherapy as some LVI seen. I’m leaning towards axial radiotherapy as I will be receiving it to breast anyway. 

Hi

I went for total clearance after I had a grade 1 and grade 2 tumour removed from my breast. They knew there was a least one node that was cancerous also but any more involvement was unclear. I opted for full clearance. It turned out 2 out of 30 nodes removed were cancerous. I'm glad now though that they've all been removed and my surgeon after I'd made my decision felt that was the right step for me too. Having the full clearance hasn't been easy post surgery with tightness,soreness, cording and a seroma developing. As long as you keep up with the exercises they give you though my arm is now feeling much stronger 2 months post surgery. I'm also having radiotherapy in a couple of weeks but that is for my breast not the node clearance. Everyone's case is slightly different. I hope this helps a little 

I was offered same choice but as I have still a lot of nerve damage in my right arm I was told if I opt for surgery I will have permanent pain in my arm .  That’s not to say you would have the same. The surgeon says it wasn’t easy to remove the four that were removed. So I’m opting for radiotherapy to both breast and armpit.