Stage II w/Lymph Node Involvement
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Miles2Go - Yes, I opted for rads and chemo, but went outside the 'standard of care'. I refused the ALND, did chemo, and only radiated the axilla and superclavical, not my chest wall. It was a personal decision I made based upon my particular pathology, the research I did, plus talking with several different medical and radiation oncologists. Also taking Tamoxifen now.
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BMX with 2 positive nodes, complete AND and chemo, no rads.
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Miles2go - There have been several studies published this year that show improved outcome (less local recurrance and metastatic disease) in women wiith 1-3 positive nodes who were treated with radiation. Also, some studies looking at radiation to the node areas (axillary and supraclavicular) in addition to whole breast radiation in women who had lumpectomies, showing probable benefit. I have pasted links to some information including from teh research section of breastcancer.org below. This seems to be a hot area of interest currently and new information has been released several time this year.
http://www.breastcancer.org/treatment/radiation/new_research/20111009.jsp
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Miles2go- Yes i opted for chemo & rads.
Once there is lymph node involvement it is more likely (not absolute) that there may be stray cells that escaped the local area. Chemo is systemic treatment and goobles up those cells.The rads is to minimize chances of a local recurrence. The benefit received from chemo and/or rads depends on each womens specific breast cancer characteristics.
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I had radiation, too. I had 2 lymph nodes involved with MACROmets...(don't hear that too often!) As we learn, there is seldom two diagnosis exactly the same. None of us really know what is the ideal treatment but this is what I know.....The best decision is my decison. Simple as that. Move forward and love yourself...
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I think it's great this thread exists. I was diagnosed this year at 28 yr old with stage II, one node infected. My team at NYU and I decided the best treatment for me was a double MX, chemo and tamoxifen. No radiation. It's been 6 months, I've completed my MX and my chemo (8 rounds). I just started tamoxifen last week.
Warrior517 said it best when she said there are seldom two diagnosis exactly the same, but I know for me it was helpful to see what other people's treatment plans are so I'm posting my own.
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I had chemo, mx, ALND, rads to breast, supraclavical and underarm lymphnodes. Doctors felt this was warranted given lymphatic invasion. The new Rads research regarding women with 1-3 nodes and rads to underarm nodes came out just as I started radiation, so this is what we went with. Maybe it was overkill, but I still worry.
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I had a 2 positive nodes and IDC. I had a lumpectomy and radiation.
edited to add that I also had AC and T and herceptin. But was responding to the radiation question above. Didn't want to confuse anyone about nodes/treatment. Chemo was pretty standard with nodes when I was treated last year.
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I had 2 positive nodes and am triple negative staged IIb. I had 4 DD AC and 8 taxol I'm in the middle of 33 rounds of RADs. I went full board tilt with what my onc suggested. Also I tested positive for the BRCA 1 gene
so next week will be going in for a total hysterectomy/ oopherectomy. My outlook was not to save pieces and parts of myself but to ensure that I would live and god willing only lose one year to this crap.
I think everyone has got to do what feels right to them.
blessings!
L
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1 positive node, lumpectomy, nodes removed, radiation 30 times including 5 boosters....we threw everything except the kitchen sink at it....was my 2nd cancer diagnosis (after cervical) so was worried...already had rad hyst with 1st cancer. Everyone's treatment plan can be so different....I m guessing depending on many personal factors plus Doc.
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I had mastectomy in July, was told that i had very wide margins, no vascular invasion, no lymph node involvement. Excellent prognosis, just go on arrimidex. I went to Memorial Sloan Kettering and they found vascuar invasion and 100 cells in one l ymph node. Was told 100 cells are not supposed to "count" but the dr felt they did. Well, yeah! From a localized tumor near the nipple those cells made it all the way through my big breast to my lymph node! They decided CMF chemo was the way to go, no radiation. I still don't understand what 100 cells means. Under 200 is not supposed to be a micromet but it's something. I think the shock of that different diagnosis is almost as bad as the shock of the original diagnosis. Maybe worse.
I'm a worrier. The dr said that node is gone, the breast is gone, don't worry. Well, there are still a lot of nodes in there. Had they found the cells on the operating table I have a hunch they would have removed all of the nodes but they didn't. So how do I know what is in the other nodes?
I will be on CMF for 6 months. So far 2 of the 3 weeks of the cycle is not bad. I still have hair although it's getting thin. I am tired. But it's the first week that is the roughest. One dr tells me I will only get 1% advantage from the chemo. The Sloan dr said 3% possibly. But bottom line, no one knows.
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I had 3 postitive nodes...bmx anld and in the middle of chemo. Rads are recommended for me as a trip neg gal. Rad Onc said risk of recurrence withouth is 33% with it goes down to 7%...that was enough to convince me to get the rads. Trip negs have no tamox or other 5 yr drug to help avoid recurrence so hit it hard with all you got.
Maggie
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Maggie-
thats where I am at 'the trip neg throw the kitchen sink and anything else at it' club.
I am strong enough to do this is what I tell myself every day. and by noon I start to believe it.
L
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timbuktu... The chemo will kill any rogue cells... your doctors have chosen the route that is best for you... You need to trust it. I had a simlar diagnosis and treatment... I believe in it.
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Had lumpactomey and sentanal node 1 outa 2 came back positive.The surgeon said she wanted to go back in and take out more nodes I have had chemo, start rads on monday.Now surgeon has changed her mind on taking out more lymph nodes and was told there is a 26% chance more nodes have cancer.I want the surgery but the Dr refuses to do it.Anyone else dealt with this situation.
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I had one micromet out of 2 nodes... they did not take more nodes... Mine was super small and they said I had a 1% chance there was more cancer.... Then I had another surgeon run some numbers on the stats (some scale) and my odds were about 5% risk BEFORE chemo... but I had chemo, so that helps reduce the risk a lot.. How big was the nodal cancer?
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My node was only 2 mm I was told very small but they said they run a test on size of tumor 3.7 cm and grade 3 thats where they came up with 26% chance of more nodes being infected.
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Turned 56 yesterday and became a 7 year Survivor today!
So far so good
)
Marcia0 -
Congrats Marcia 7 years is so good to hear.Gives me hope.
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Congratulations, Marcia!!! That is really great!!
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congrats marcia!!! can't wait to post my 7 yr.........in 7 yrs!!!!
sandy, i kind of had the same thing....kinda. surgeon wanted to go back in, but onc said wasn't necessary. they didn't give me the % at all, but i wish i had known.....or asked. would i have done something different w/ the info?? i don't know, but i really do think about the stupid node involvement a WHOLE lot.....i am sad to say that. i wish i could turn it off, but i am never going to stop trying. i wish i had the peace of mind of having the surgeon going back in. i know there is the risk of lymphedema (Sp?).....but i could live w/ that as opposed the risk of nodes being+. i had chemo and rads too.....after surgery. so, best of luck to you and maybe you can get a second opinion and go from there. i try really hard not to beat my self up (although i don't do a great job of it) over not pushing for more nodes. i can really say that i made the best decisions i could based on the info i had while dealing w/ the emotional issues that come w/ being told....you have cancer.
much love to all of my sisters!
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Hi
I am new to this site. I am 42. I was diagnosed July 2011 with IDC. I had a double mastectomy Nov 1, 2011. I also had my ovaries and tubes removed and started reconstruction. I found out Nov 22 my lymph nodes are positive on the right side. I have appointments this week to discuss radiation, chemo and maybe more surgery.
Between the hot flashes and the expanders I am miserable. I am wondering if anyone has had surgery to remove more lymph nodes after the BMX????
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Amazing! Thank you for this thread! I feel encouraged. It has been a week of anxiety after being told intially it was non-invasive to invasive and 1 node micromet. It's been 2 surgeries, mastecomy and failed tissue expander (infection). I am awaiting the 2nd pathology this wed.
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camary - yes, it is more common than you think. I had a BMX in Nov. '10, BS thought SNB was initially negative. Post-op path showed micromet, 5 weeks later I had a complete axillary node dissection, 1 additional node, but it had a 6 mm area. I did not require rads but I already knew I was having chemo because I was triple positive. Both my BS and MO did not feel chemo was adequate to take care of the additional - they both required that the remaining nodes come out. No regrets.
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SpecialK.. it makes me worry and wonder that your doctors say that... I had a micromet (.38mm) and was told the odds of more so so so small... and then there you are with another node positive... And my MO says the chemo would kill anything else out there and didn't want to risk lymphadema... Its all so scary... I did have 6tx of TC... so if there was something else, I sure hope it zapped it... How big was your micromet?
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bdavis - the micromet in my SNB was <20 cells and the one further up the chain was 6mm. I argued against the node dissection but they both were adament. My BS was one of the pioneers of SNB, he is not a slash and burn kind of surgeon, so I felt pretty compelled. I don't want you to be scared but I am sure you have read about ladies on these threads who have had neoadjuvent chemo but still had positive nodes after - just smaller ones.
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Yes.. I asked for more nodes and both my MO and BS said not necessary.. then has another BS agree... AND THEN, I had one of my MO's partners ask me why I didn't have more... I was not happy...I tried to point out people like you, that it happens... and they assured me that the .38mm is so so small that it is almost like node negative.. plus it had another node attached to it that was negative... my BS said she thinks had it spread, it would have been in the attached node... And again, thats why they gave me extra chemo.... I know there are women who get chemo and still have positive nodes.. so of course that is worrisome... but I have to trust my MO... right?
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I would prefer to have more nodes taken out especially with a 26 % chance there could be more infected I think that is a big precentage not happy the surgeon refuses to take out more and it would take to long time to get a second opinion here in Canada since I start Rads tommorow very fustrating.
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I do wish I knew exactly where the additional node was geographically. Was it the very next one to the SNB? The size differential was pretty dramatic but my BS also said that happens about 20% of the time. Not having one standard way to handle this situation makes it very nervewracking I think, because we are left wondering which way is best. I have to say I am glad they removed the nodes later - even though that surgery was worse than the BMX and I do have mild LE. I was happier knowing they were out! Like many things with BC stats in the future will inform us, but in the short term we do have to trust the advice we have been given.
You guys made me laugh though - seems like everyone else is fighting their BS to keep their nodes!
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Treatment options will continually change. One must be fully confident in that their Medical team gave the best options at the time with the knowledge they had at the time..
My treatment would be different today, 7 years later, BUT the proof is"in the pudding"and I am still here!
There is simply no way to determine who will recur and who will not..:(
gentle hugs,
Marcia
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