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Aug 5, 2012 08:51 PM wildrumara wrote:
apamelahope - I too had neoadjuvant chemotherapy and did not have SNB before surgery. All my imaging studies showed no evidence of enlarged lymph nodes. During my BMX, a SNB was performed and I had 3 sentinel nodes, 2 of which just crossed the threshold of being positive. Because I had neoadjuvant chemo and still had positive lymph nodes, my surgeon did an ALND for a total of 20 removed. The two sentinels were the only positive nodes. My friend, who is a pathologist at the hospital where I had my surgery, said that pathologists often see "dead tissue" in the nodes of patient's who undergo neoadjuvant chemotherapy, if those nodes were once positive. They can often tell when nodes were positive before chemo as this particular necrotic tissue is present under the microscope. I know at the hospital where I had my surgery, the pathologists often state that in the path report...."necrotic tissue found in nodes", or whatever.
As far as radiation goes, having the 2 positive nodes put me in a "gray" area regarding radiation based on a few of the latest studies out there. I had two consultations. One RO said did recommend radiation for me because of the two nodes being positive, and the other said it he would not....that the risks outweighed the benefit for me, especially considering my pathology report with smallish tumors, no LVI, great margins, and ALND. It took me a few weeks of research, communicating with women on these boards, and talking and e-mailing one of the ROs a few times to come to the decision that I would NOT do radiation.
If you have any other questions, please feel free to private message me.......I can give you more details regarding my decision regarding radiation and my plastic surgery choice, etc.....
Wildrumara Oncotype score 25, onto neoadjuvant chemo TC X 6 finished on 01/17, BMX with direct to implant reconstruction, and ALND. 2/20 nodes positive.
Dx 8/23/2011, IDC, 2cm, Stage Ib, Grade 2, 2/20 nodes, ER+/PR+, HER2-Chemotherapy 09/30/2011 Cytoxan, TaxotereSurgery 02/29/2012 Mastectomy (Both); Reconstruction: Breast implants (permanent) (Both)