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All TopicsForum: Radiation Therapy - Before, During and After → Topic: Stage IIIB - RADS to the Internal Mammary Nodes?

Topic: Stage IIIB - RADS to the Internal Mammary Nodes?

Forum: Radiation Therapy - Before, During and After — What to expect from treatment and ways to cope with side effects.

Posted on: Jan 15, 2010 05:58PM

precioustime wrote:

If anyone ever has had RADS to their Internal Mammary please advise and let me know how it went?  A little concerned about getting radiation to the middle of my chest area (Internal Mammary on both sides)!  I will also be getting RADS to chest wall and axilla and clavicle area.  ThanksSmile

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Jan 17, 2010 08:30PM ccbaby wrote:

Yes, I had radiation to my internal mammary lymph nodes as well as the chest wall, superclavicle and axilla area.  To be totally honest with you, I burned very badly there and the burns showed up at the last week of the treatments when I was getting my boosts. I have been using silvadene and derma-plex ever since and my radiation ended 3 months ago. They are very slowly getting better. I don't know why I burned so badly there and this does not mean it will happen to you. I am going in to the hospital tomorrow to have my herceptin treatment and I am going to stop in at radiology and have them look at me again.

~Christy~ left side mastectomy/TE February 2009 Finished TC July 2009 Rads finished Oct 2009 Stage 1 lymphedema Removed failed TE, HIP flap surgery Dec 2009 Finished Herceptin March 2010 Second stage March 2010 Third stage revisions Oct 2011

Dx 1/29/2009, IDC, 3cm, Stage II, Grade 3, 1/13 nodes, ER-/PR-, HER2+
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Jan 18, 2010 09:09AM Leah_S wrote:

I also had rads to nodes in sternum, in addition to chest wall and supraclavicular nodes. The inframammary (in the sternum) were done in the way boosts are, targeted electrons. I also had more skin problems in that area than in the rest  of the skin. I had a bolus but no boosts.

Leah

Dx 11/3/2008, IDC, 1cm, Stage IV, Grade 3, 6/17 nodes, ER+/PR+, HER2-
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Jan 18, 2010 09:12AM Leah_S wrote:

Just want to add - since you're getting rads to supraclavicular area, make sure to use aloe vera (or whatever you are using to prevent burns) all the way up the side of your neck and your back at the top of you shoulder. The rads go up the side of your neck in addition to exiting on you back (area behind the clavicle).

Best of luck with rads.

Leah

Dx 11/3/2008, IDC, 1cm, Stage IV, Grade 3, 6/17 nodes, ER+/PR+, HER2-
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Jan 18, 2010 10:40AM, edited Jan 18, 2010 10:44AM by precioustime

Thank you so Much Leah.. I didn't know that about using lotion all the way up to the neck Smile What exactly is a Bolus? My Oncologist mentioned I would be getting a Bolus-- nothing about Boosts...

CCBaby - Hope you get better real soon!  You made it through RADS!!!

Dx 6/9/2009, IDC, Stage IIIc, Grade 2, 12/18 nodes, ER+/PR+, HER2-
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Jan 18, 2010 11:06AM ccbaby wrote:

 A bolus is a rubbery material, is used to 'fool' the radiation beam so it will deposit the maximum dose on the skin surface instead of a fraction of an inch deeper, as it would otherwise. They used a bolus on me too, but every 4th day would remove it. By reading these boards, it seems like every hospital's protocol is different as to how often they use it.  Good luck with your radiation and keep us updated!

~Christy~ left side mastectomy/TE February 2009 Finished TC July 2009 Rads finished Oct 2009 Stage 1 lymphedema Removed failed TE, HIP flap surgery Dec 2009 Finished Herceptin March 2010 Second stage March 2010 Third stage revisions Oct 2011

Dx 1/29/2009, IDC, 3cm, Stage II, Grade 3, 1/13 nodes, ER-/PR-, HER2+
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Jan 18, 2010 11:11AM clariceak wrote:

So glad you posted this. I start rads for one of my internal mammary nodes in March and have no idea what to expect.  I was so ignorant when I first started this process when they told me I had cancer in one of my mammary nodes I wasn't even concerned because I thought it would come out with my bilat.

precioustime - when do you start rads and for how long?

Chemo, rads, Femera, Zometa, Ooph

Dx 9/8/2009, IDC, Stage IIIc, 9/35 nodes, PR+, HER2-Surgery Mastectomy (Left); Lymph Node Removal: Axillary Lymph Node Dissection (Left); Prophylactic Mastectomy (Right); Prophylactic Ovary Removal (Both)Chemotherapy 10/06/2009 Adriamycin, TaxolRadiation Therapy 03/24/2010 ExternalHormonal Therapy 05/10/2010 Femara
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Jan 18, 2010 11:23AM precioustime wrote:

Clariceak-  I also thought they could remove the internal mammary node with surgery after having a biopsy of the node...  I have done alot of research on this since I found out in June/09 and really haven't come across much info.  I guess we are in the low percentage rate of getting cancer to the internal mammary node---OR maybe there are women that do have cancer to those nodes but are not detected by MRI/PET scan?  I have had NeoAdjudvant Chemo that started 6/09 which shrank the node 1/4 of the size it was and then BMX with rt. axila dissection 12/09.  My last treatment will be RADS that will start in Feb/10 when they have everything set up for me on the TOMO machine.  I believe the Radiation Oncologist said that she hasn't had that many ladies with this area of involvement but she feels confident that RADS will get rid of the cancer.  I believe it will be 33 rounds using a Bolus.  We will make it through this!

CCBaby-- Thank you for all your information.  It really helps to have those who have been through it give us their stories. 

Dx 6/9/2009, IDC, Stage IIIc, Grade 2, 12/18 nodes, ER+/PR+, HER2-
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Jan 18, 2010 11:30AM clariceak wrote:

Mine is hiding behind a bone, so no surgery was recommended.  I'll be treated in California but my onc is in Seattle.  She said treatment would be six weeks, but based on your info, perhaps longer.  I'll try not to fuss about it yet, since my kids are in Alaska and I have to travel for treatment.

I thought leaving them for 4 weeks would be a long time...

Chemo, rads, Femera, Zometa, Ooph

Dx 9/8/2009, IDC, Stage IIIc, 9/35 nodes, PR+, HER2-Surgery Mastectomy (Left); Lymph Node Removal: Axillary Lymph Node Dissection (Left); Prophylactic Mastectomy (Right); Prophylactic Ovary Removal (Both)Chemotherapy 10/06/2009 Adriamycin, TaxolRadiation Therapy 03/24/2010 ExternalHormonal Therapy 05/10/2010 Femara
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Jan 18, 2010 11:30AM TammyLou wrote:

YUP.  Seatbelts = torture instrument for a couple of months.

A pillow placed between you and seatbelt helps.

Several years out now.

Some damage to  a few ribs, cartilage.

I had some serious muscle spasms for several years...spontaneous charlie horse-like.

Currently, a pickle jar is the enemy, but most of the spontaneous sorts of spasms are a thing of the past.

I take 15mg Mobic daily...helps ALOT with the general (and specific) types of aches and pains that can accompany high dose cancer treatments.

tl

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Jan 18, 2010 12:32PM precioustime wrote:

TammyLou = You also had RADS to Internal Mammary?  What area of ribs were damaged?  I already have sensitive ribs from the Surgery!  ouch.   Also-- was Mobic over the counter?  Thanks for your help...

Dx 6/9/2009, IDC, Stage IIIc, Grade 2, 12/18 nodes, ER+/PR+, HER2-
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Jan 19, 2010 10:59AM jacee wrote:

Thanks for this info. Had one mammary node that was a sentinel node and was positive. Surgeon was able to remove it...first one she'd ever removed. Just finished chemo Jan 4th and will start rads in Feb. Meet with rad onc in a week. Don't EVEN know what to ask about the mammary node area.

My body has cancer, my spirit does not!

Dx 4/27/2009, IDC, <1cm, Stage IIa, Grade 1, 3/11 nodes, ER+/PR+, HER2-Surgery 05/05/2009 Prophylactic Ovary Removal (Both)Surgery 06/06/2009 Mastectomy (Right); Lymph Node Removal: Axillary Lymph Node Dissection (Right)Chemotherapy 07/06/2009 Adriamycin, Cytoxan, TaxolHormonal Therapy 01/04/2010 FemaraRadiation Therapy 02/12/2010 ExternalSurgery 09/09/2010 Prophylactic Mastectomy (Left); Reconstruction: DIEP flap (Both)Surgery 10/09/2011 Reconstruction: Nipple reconstruction (Both)
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Jan 19, 2010 11:31AM JacquelineG wrote:

I too had an internal mammary node positive (in addition to 6 axillary nodes) and had rads to that area. I got a little redder and itchier there than other areas but really no big deal. I made it through rads with no problem with a lot of Vitamin E (broke capsules and rubbed right after rads, in dressing room!) and aloe vera. You will be fine! I ended rads almost a year ago and have been fine. I had a bit of a cough for a while that they thought might be rads related (set in about 3 months after rads) but now that's gone too.

Best of luck -- you'll get through this!

Jackie

Dx 6/2/2008, IDC, 2cm, Stage IIIc, Grade 3, 6/40 nodes, ER+/PR-, HER2-
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Jan 27, 2010 01:53PM weety wrote:

jacee, how did they know your intramammary node was a sentinal lymph node?  Did you have the radioactive dye during surgery and that is the one that lit up?  I ask because I had an inner tumor (right at the cleavage) and the surgeon kept mentioning the possiblility of having it drain to the intramammary nodes rather than the axillary because of its position. (Was your tumor an inner one?)   He basically told me that they don't surgically remove those, though.  During surgery a sentinel lymph node "lit up" that was axillary.  Does that mean my intramammary nodes were not a sentinel since they did not light up? 

Dx 7/17/2009, IDC, <1cm, Stage Ib, Grade 3, 0/1 nodes, ER+/PR-, HER2+Targeted Therapy HerceptinHormonal Therapy FemaraSurgery Mastectomy (Left)Radiation Therapy ExternalChemotherapy carboplatin, TaxotereSurgery 04/19/2010 Prophylactic Ovary Removal (Both)Surgery 04/10/2013 Prophylactic Mastectomy (Right)
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Jan 28, 2010 09:17PM, edited Jan 28, 2010 09:21PM by jacee

weety-I actually had 2 sentinel nodes. I had the blue dye and the radioisotopes. Both traveled to the sentinel nodes. The strange thing was  my tumor (7mm) was in the outer quadrant of my rt breast. I had one axillary sentinel node and one intramammary sentinel node. They were both positive. The mammary node involved was the top one which is probably why she was able to remove it. Of course, she didn't know it was positive until the pathology was done. I'm really glad she was able to remove it. So crazy that my tumor was so small, yet drained to both the axillary and intramammary nodes!! 

I believe it does mean that your mammary node was not a sentinel node, since it didn't light  up. Good news for you. Are you having radiation? I start next week I think. Had my simulation on Tuesday. I'm a little nervous having the mammary node area radiated. 

My body has cancer, my spirit does not!

Dx 4/27/2009, IDC, <1cm, Stage IIa, Grade 1, 3/11 nodes, ER+/PR+, HER2-Surgery 05/05/2009 Prophylactic Ovary Removal (Both)Surgery 06/06/2009 Mastectomy (Right); Lymph Node Removal: Axillary Lymph Node Dissection (Right)Chemotherapy 07/06/2009 Adriamycin, Cytoxan, TaxolHormonal Therapy 01/04/2010 FemaraRadiation Therapy 02/12/2010 ExternalSurgery 09/09/2010 Prophylactic Mastectomy (Left); Reconstruction: DIEP flap (Both)Surgery 10/09/2011 Reconstruction: Nipple reconstruction (Both)
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Jan 29, 2010 02:37PM precioustime wrote:

Jacee-

I also start RADS on Monday 2/1/10!  I was going to start this week but the TOMO machine has been down.  I too am a little nervous having the mammory node area radiated-- they are going to radiate both sides of the internal mammary. 

I had 12 axilla nodes positive per PATH report and 1 internal mammary node that was biopsied positive.  My case is a little different because I had (3) tumors in the rt. breast. 

Neo-Chemo got rid of 1 tumor and made the internal mammary node shrink 1/4 of the size it was.

Hang in there during RADS-- WE WILL MAKE IT THRU!

Loretta

Dx 6/9/2009, IDC, Stage IIIc, Grade 2, 12/18 nodes, ER+/PR+, HER2-
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Jan 29, 2010 04:52PM jacee wrote:

Loretta... We will just travel this road together then. I should find out my start date this coming week. I did ask the rads onc if both sides of my mammary nodes would be radiated. He said "no, just the right side". He did say I would definitely have a small amount of lung scarring. I'm not sure now if that's due to the IM nodes being radiated or the radiation in general. He said I shouldn't ever even notice unless I'm running a marathon. Not sure I believe that.

So glad the neo chemo worked well for you. Maybe we should get on a Feb rads thread if there is one. Found out I will be having 30 treatments.

Joni

My body has cancer, my spirit does not!

Dx 4/27/2009, IDC, <1cm, Stage IIa, Grade 1, 3/11 nodes, ER+/PR+, HER2-Surgery 05/05/2009 Prophylactic Ovary Removal (Both)Surgery 06/06/2009 Mastectomy (Right); Lymph Node Removal: Axillary Lymph Node Dissection (Right)Chemotherapy 07/06/2009 Adriamycin, Cytoxan, TaxolHormonal Therapy 01/04/2010 FemaraRadiation Therapy 02/12/2010 ExternalSurgery 09/09/2010 Prophylactic Mastectomy (Left); Reconstruction: DIEP flap (Both)Surgery 10/09/2011 Reconstruction: Nipple reconstruction (Both)
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Jan 29, 2010 08:33PM precioustime wrote:

Jacee-  I think that they have already started a Feb Rads thread and I will probably go on Monday after 1st Treatment to introduce myself.  I was on the Jan. Rads thread but Rads had been postponed due to the TOMO machine breaking. 

We will travel together and get through to share our storySmile

Dx 6/9/2009, IDC, Stage IIIc, Grade 2, 12/18 nodes, ER+/PR+, HER2-
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Feb 3, 2010 01:45PM jenn3 wrote:

Some good information here.  I am also having rads to my mammory nodes, clavical and axilla. The rad nurse told me just yesterday to make sure to rub the lotion and/or Aloe up my neck and to be sure to get my back too.  I hadn't even thought about my back....... I'm only 6 days in and have noticed that my seat belt rubs right along the area being treated - guess I'll have to get a small pillow for the car - good suggestion.

Jenn - June 2009 IDC-TN, Stage III, 02/2011 Stage IV mets to the lungs & spine / Laugh until your belly hurts, then laugh some more...........

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Feb 3, 2010 02:03PM, edited Feb 3, 2010 02:11PM by thenewme

I also had rads to IM node that was "suspicious" on PET scan.  It was done together with the other areas of rads, and I didn't really notice anything different or worse about the effects on that area compared to the rest of the skin.  I still have my chemo port in, which has always been bothered by seatbelts, so I didn't notice that with rads.  I had some difficulty swallowing (like a lump in my throat) for a long time, but it's gradually going away, and my sternum still feels very tender, but they don't know why.  Another PET scan was clear after rads (the IM node disappeared), but I do have several lung nodules that are hopefully nothing.  Anyway, best of luck with you all starting this rads journey!  Feel free to ask questions!  All in all, the rads was a piece of cake (...saying that always reminds me of Konakat, teehee) for me compared to surgery and chemo.  Take care!

Dx 11/2008, IDC, 5cm, Stage IIb, Grade 3, 0/9 nodes, ER-/PR-, HER2-
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Feb 3, 2010 02:04PM precioustime wrote:

Jenn-

This evening will be treatment #3 using the TOMO machine and rads to same areas as you as well as the chest wall and using a bollus on me for 33 treatments!  I am just having a really hard time with this mammory node thing!  Could it be because there are not too many women out there who have gone through it and not much info. out about it? 

I will definitely be putting the lotion on everywhere!

Treatment will soon be over for us and we'll be able to help other ladies going throughSmile

Loretta

Dx 6/9/2009, IDC, Stage IIIc, Grade 2, 12/18 nodes, ER+/PR+, HER2-
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Feb 4, 2010 04:31AM katiedid wrote:

Ladies, I am finishing my radiation next week with my last 5 boosts...I did have 10+ ax nodes so I got rads under my arm. I use a deodant without alchol named crystal it's a roll on that I also use under my breast that helps dry it out and I have no sores there that most women will have..under my arm is my sore spot because of the scar and the bend of the arm. Remember radiation has to come out so you will have to use the Aloe on your clavical, shoulder, and back too..I use all kinds of lotions but I just have to be clean 2 hrs before I get rads in the spots getting the rads.....I worked through chemo, without trouble, surgery was ok, radiation I leave work everyday at 3 to drive the 50 miles to tx but it's only been this last week that I have noticed some fatigue. It is getting worse and I'm afraid with the last boost I will have to fight it, but I will. I'm a 51 yr old woman that was jogging 5k's when we found the lump and I will start walking the 1k's at the end of this month to start again....I stopped the 1k's in the middle of chemo, it got to much.  You will be able to get through this, eat right, sleep when you need too, and don't forget to ask for help when you need too...

Dx 6/12/2009, 6cm+, Stage IIIb, 10/22 nodes, ER+/PR-, HER2-
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Apr 4, 2010 11:16PM jccoldwell wrote:

Hi!  I hope that all is well with you.  I'm so glad that you told me about this site.  You were a blessing to me at CCA.  I always looked forward to seeing you.  I'm getting a hysterectomy on April 14th.  I was pretty scared after the ultrasound because it was looking like uterine cancer.  PTL that's NOT!  One more journey to get through friend....every test is so scary.  I wish the best for you friend!

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Apr 26, 2010 02:50AM katiedid wrote:

I am doing great and I think about you often....I'm glad you read this site, it has helped me a lot..send me a message and let me know how you did with your surgery.  I just had my PET scan and was reading about bone mets....I don't think anything is wrong but a woman needs to know her business at all times......PTL yes, it wasn't and PTL he put us together....I will always think of you and will probably see you for check ups....Good luck...Friend...

Dx 6/12/2009, 6cm+, Stage IIIb, 10/22 nodes, ER+/PR-, HER2-
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Mar 15, 2011 10:10PM pamgroth wrote:

Does anyone know if it's possible to have radiation on the internal mammary nodes with implants?

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Apr 2, 2011 03:02PM precioustime wrote:

Hello Pamgroth- I believe with the Tomo machine they can pin point any area of concern.  I had a bilateral mastectomy and am 1 yr. out from radiation treatments and made it through- thanks be to God!!   My last PET scan on 6/2009 showed "No evidence of Tumor"  -- so just want to encourage you that even though your internal mammary nodes may be effected - RADS can work!

Dx 6/9/2009, IDC, Stage IIIc, Grade 2, 12/18 nodes, ER+/PR+, HER2-
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Apr 6, 2011 07:20AM anneflorida wrote:

Last summer I had radiation to the internal mammary nodes as well as my chest wall, axilla, and supraclavicular.  I had no evidence of a positive internal mammary node but the ro said that because my tumor was 8cm it was possible that it drained to that area.  I had burns that were in all the areas that they radiated and that was with using precise radiation( modulated radiation).  All my radiated areas opened up and were weepy.  The good news is that I used Aquaphor with a special dressing over all the burns and actually the burns did not hurt too much though they looked really bad.  I did not even take aspirin for pain.  The burns also healed quickly and I consoled myself with the thought that all cancer cells in the area were fried!  

Dx 12/12/2009, IDC, 6cm+, Stage IIIa, Grade 3, 9/28 nodes, ER+/PR+, HER2-
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May 8, 2011 04:11PM bak94 wrote:

Im confused about the internal mammary nodes. I have several positive found on pet scan, but no auxillary nodes positive. I just had my first AC. Can I survive this? What if they can't get those pesky nodes? My doc says it is still local disease. It seems finding intrernal mammary nodes positive is a new thing. Do you think that in past cases they were positve but went unnoticed because of lack of testing and the nwhere killed by chemo anyways? It does still seem pretty rare and it is hard to find info on.

Not really sure what stage I am-Some docs say 3C, others say stage 4. I had no auxillary nodes positive but had internal mammary nodes positive and possibly mediastinal node positive. It's just a number anyways, right?

Dx 12/15/2002, IDC, 3cm, Stage IIb, Grade 3, 2/40 nodes, ER-/PR-, HER2-Dx 4/5/2011, IDC, 2cm, Stage IIIc, Grade 3, 0/2 nodes, ER-/PR-, HER2-Surgery 01/02/2003 Lumpectomy (Right); Lymph Node Removal: Axillary Lymph Node Dissection (Right)Chemotherapy 02/05/2003 Adriamycin, TaxolRadiation Therapy 07/08/2003 ExternalChemotherapy 04/27/2011 Adriamycin, CytoxanTargeted Therapy 05/14/2011 AvastinChemotherapy 07/29/2011 AbraxaneSurgery 11/30/2011 Mastectomy (Both)Radiation Therapy 02/11/2012 ExternalHormonal Therapy 04/10/2012 AromasinHormonal Therapy 08/02/2012 Tamoxifen
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May 8, 2011 09:34PM jacee wrote:

bkj66- YES, you CAN survive this. Have you had any surgery yet? AC is a powerful chemo. I had that, then Taxol, then rads. The last 7 rad treatments were directly to the Internal Mammary Nodes. I had a sentinel node that was an IMN. They removed it.

You're right, IMN involvement is rare, but isn't a death sentence. Hang in there, and stay in touch with some ladies on this board. Are you in a chemo group? There's probably a May 2011 thread under the Chemotherapy Board. It's great for all the ladies who are doing chemo at the same time. You will find much comfort there.

Hugs to you...Joni

My body has cancer, my spirit does not!

Dx 4/27/2009, IDC, <1cm, Stage IIa, Grade 1, 3/11 nodes, ER+/PR+, HER2-Surgery 05/05/2009 Prophylactic Ovary Removal (Both)Surgery 06/06/2009 Mastectomy (Right); Lymph Node Removal: Axillary Lymph Node Dissection (Right)Chemotherapy 07/06/2009 Adriamycin, Cytoxan, TaxolHormonal Therapy 01/04/2010 FemaraRadiation Therapy 02/12/2010 ExternalSurgery 09/09/2010 Prophylactic Mastectomy (Left); Reconstruction: DIEP flap (Both)Surgery 10/09/2011 Reconstruction: Nipple reconstruction (Both)