Stage II w/Lymph Node Involvement
Comments
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Sandy - There have been some studies supporting no AND after positive sentinal node in women who are going to receive radiation anyway. Talk to your RO, maybe you fall into this group.
Below is the link to the site on BCO that talks about it.
http://www.breastcancer.org/treatment/surgery/new_research/20100608b.jsp
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I know the new study says no more aux nodes to be taken after sentanl node surgery but R O agreed with me about having them out for my piece of mind.He also said if the BS was going to take them out she should have taken them out before Chemo.A chance of 26% of more infected nodes is to much as far as im concerned.The Ro said he would speak to my BS again see if she will change her mind and take out the rest of the nodes meanwhile my 1st Rads were to be done this morning and now put on hold waiting to hear from my BS which could could take forever.
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I agree, sandy. Glad my surgeon took the rest of the aux nodes out. I DO have greater peace of mind as a result.
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yorkiemom did the surgeon take them all out the 1st time or go back in to take more out.I have heard its hard finding a surgeon to go back in.
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Hi Ladies- hope you are all doing well today. I am enjoying reading all of your posts, so much good info being shared!
I have an "unusual" diagnosis & was wondering if anyone else had a similar situation. I have stage II non-agressive carcinoma's (2 separate, same breast) with ductal & lobular characteristics. The wierd part, is that I had 6 out of 10 positive nodes. They wondered I was getting annual screening mammograms, the answer to that is "yes". Because of the lymph node involvement, the MO said that if I did not do any treatment I have a 50% chance of recurrence (Yikes!!). The MO said that both Chemo & RADS are non-negotiable since that would bring my chance of recurrence down to about 20%. Of course, I signed up for both.
I was thinking that 20% chance of recurrence is a good thing since the general population has a 16% of breast cancer. But reading this discussion board it seems that the average chance of recurrence is much lower (7% - 10%). I am finding my situation really scary. As usual, I do not neatly fit into a "box". Ugh!!
Sending healing vibes to all :-)
Love {{{HUGS}}} & Prayers
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Rose,
Our signature lines are similar so I thought I'd share what my onc told me. With a BMX, chemo, rads, 5 years of Tamoxifen and then 5 years of AI he put my recurrence risk at right around 10%. I, too, had two separate tumors in the same breast. There's a much greater chance that we will NEVER have to deal with this again than having it recur.0 -
Rose.....I would look at this as a better than 80% chance of being just fine, provided you do all the treatment they recommend. You will most likely need anti-hormonal meds too.
The other thing to remember is that these stats measure the effectiveness of treatment ten years ago, so I would think the real numbers are higher now.
None of this is fun, but hardly the end of the world either. It will help if you can get at least some exercise.
Good luck with everything!!! - Claire
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I think the numbers can be hard to understand,... I have a 14% risk of systemic recurrance and was told I'd have a 15% risk of local recurrance had I had radiation and the lumpectomy... So I chose BMX to reduce my local recurrance... BUT all doctors agreed I did not need radiation since I had the MX, but I worried about the regional recurrance.. I am told the chemo woul dhave taken care of things.... SO... I am thinking my risk of systemic recurrance remains at 14%, but risk of local drops to 2% with BMX... So I don't think a 20% risk is extreme and I agree its an 80% chance you are all good.
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Sandy, she took them out during the original surgery. Tested 4 sentinel nodes and when 2 came back positive, she took out 19 more. I know that is different from your situation. Surgery is no fun, and the big incision under the arm is still tender for me, but I would go under a second time to bring me peace of mind. Lots of people here are posting odds that it doesn't matter if more nodes are taken, and maybe it doesn't. I can only give you my gut feeling. Don't have any stats. I also don't know how hard it would be to find a willing and experienced surgeon. Nothing is lost by looking around and asking folks.
Best wishes!
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sandy - axillary node dissection is also when you want a very experienced surgeon, and you need to ask what that surgeon's LE rate is. Generally, they underestimate it to patients, but your surgeon's skill is very important in this particular surgery.
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Sundermom - A big "thank you" for the words of encouragement. I was beginning to think that I was an unknown anamoly. I too had a BMX, am on tx#2 of 8 & then onto rads. My MO said that since I I am post-menapausal I will not be on Tamoxifen, but an AI for 5 years. Are you pre or post menapausal?
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Claire- I had a bad SE day today & it cleary infuenced my thinking. Thanks for flipping my perspective to the positive- more than 80% cance that I will not have a recurrence is great!!!
I have been very good about exercise; walk 2 x per day (1 hour at a clip when I can handle it), stretching every day & strengthening exercises every other day. I was in really good condition when I started this odessey, trying my best to keep my strength up!
I did not know that the recurrence stats were 10 years old. Interesting. I wonder why the stats are so far behind.
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Betsy- You are right, the stats are confusing. :-( I am going to have to clarify local, regional & systemic recurrence rates with my MO. Have a great night!
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Claire: We have similar stats, but I confess I have been too afraid to ask my MO for recurrance stats. I plan on doing it the next visit, so I am finding this interesting. The numbers are actually better than what I have been imagining in my mind
. Is the distance recurrence risk around 20%. I have been reading that the PR- has a worse prognosis. I had MX and RAds, including the axillary nodes. I worry because I had lymphatic invasion into my skin. 0 -
Thank you SpecialK i will ask the surgeon about her LE rate that is if she agrees to more surgery.To get a second opinion here in Canada would take months and I dont want to wait that long to start on my Rads.the RO said today there is a 25% risk of LE I do learn alot on these posts so thank you everyone.
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I had lumpectomy and SNB two weeks ago. Three lymph nodes were removed. One came back positive. 2 out of five margins not clear. Went from stage 1 to stage 2. Tumor size was 1.6 cm. Her2 neg. The breast surgeon wants to remove all lymph nodes on left. I'm concerned about lymphodema. I'll be having BMX next month and 8 rounds of Chemo. Any advice? I am thinking of going for 2nd opinion to BS, not sure why, but feel it's a good plan.
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dipad - I would definitely go for a second and third opinion. Each of our cancers are unique, thus each of us has different treatment opinions. For me, I declined the ALND and decided to radiate the axilla and supraclavical instead. My pathology indicated only a 9% probabililty that other lymph nodes were involved. I would definitely ask what the probability is for your cancer spreading to other lymph nodes. I also knew that I would be doing agressive chemo and be on Tamoxifen for 5 years. But you also need to remember there are no guarantees. Do you homework and make the best choice for you. It is your body and your life.0
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Just this week I declined an ALND after my one sentinal node came back as quite involved. As I am Her2+ I am facing chemo, herceptin and radiotherapy and I made this decision based on recent research from Memorial Sloan Kettering (google for information) and from reading a couple of recent radiology papers that showed no difference in recurrance rates for women who had ALND with no axilla radiation and chemo and women who had positive nodes without ALND but with axilla radiation and chemo. The morbities from ALND are significantly more likely than with radiation.
This view is quite new to the medical world and so many surgeons are nervous about potentially leaving some cancer in there. But if it's already in your nodes it's just as likely to be in other places too so that doesn't really make sense.
Because I turned down the clearance I went and had a staging CT scan yesterday (not standard practice here in Australia) and it came back with no evidence of mets anywhere (brain, chest, abdo, pelvis and specifically no more seen in my axilla). For any micro-mets the rest of my treatment should wipe them out which will leave my main area of likely return to be my brain. Hopefully we've caught it before anything has sneaked on up there...
I am a cancer clinical trials coordinator so may understand a whole lot more about odds ratios, survival curves and p-values but there is a whole lot of plain english information available that you should be able to find that should help you determine if you fit the criteria for non-clearance.
regards Jenn0 -
Jenn, just curious. Why would the brain be the main area of return?
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With chemo and radiation any residual cells in most of the body can be "mopped up" however most chemo drugs and herceptin do not cross the blood-brain barrier. From my reading I have learnt that brain mets for women who are Her2+ are now the main concern long term...
regards Jenn0 -
Thanks for the info Jenn. I learn so much here! How about hormonals? Can they get to the brain cells?
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Thank you for all of the great info. I saw the RO and they suggest rads and no surgery. I also saw the MO and I will get a port 12/22 and start chemo the following week. I am going to my first support meeting today. I have found reading posts here very encouraging and it gives me great questions to ask. Thanks again!
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Marybeth... I am surprised you are getting rads after a MX and only one positive node... I was told the standard is that under 3-4 nodes that radiation as not necessary... so I didn't have any. I had 4 doctors tell me that.
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I was told I would have rads either way before we even knew my node status. Thinking back, I can't remember why they told me, but I think it may have been tumor size and LVI. It's all kind of a blur now.
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That was true for me when I was having a lumpectomy... but after MX, they told me no rads needed.
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Sometimes axillary clearance is the wise path. I had a very large tumor in my sentinal node, so the assumption was that it would have a number involved (honking big tumor that could be felt). However, this was the only one affected. Yes, I would have preferred fewer nodes, but I am just fine.
TexasRose.....congrats on the exercise. I did the same thing, and I think it made a major difference in where I am at this point. Also, in my trip through. However, there is a basic recovery curve that you can't shorten further. I learned that. For me, it was roughly one year plus chemo/rads that I really had my full energy back.
Now, I really do need to get my career back on track. This is because I am assuming that I will live a long time. I want it to be a good life too. Part of "good" is "well funded".
Now just to get past this nasty cold!!! - Claire
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Hi, thanks for starting this thread warrior517, glad to find it. My mom is stage II as well, ER+/PR+, HER2-, she is 56 years old. Thank you for all the positive stories.
She got diagnosed on 10/27/2011, had one unsuccessfull surgery (margin is still positive) couple of weeks ago. needs another surgery, which is not schedualed till 2nd week of January! Had two opposite ideas from 2 different oncologist regarding chemo. Waiting time and different oponions are making us more worried and anxious!
For Her2- ladies, did you have to do chemo? The first oncologist who she saw ordered onco-type testing to see if she needs chemo or not! according to my search onco type testing is for node negative, the 2nd oncologist sugested 3 cycles of chemo (AC followed by taxotere). We are so confused and the worse is the wating time from the time that she got diagnosed till now she hasn't got the complete treatments yet, it is too scary for me and her.
Can someone please tell me how long did it take for you to start chemo after diagnosis?
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Hi A1B1,
Sorry to hear about your mom, but you've found a great place for information and support. I am Her2- and will not be getting chemo, primarily due to my low Oncotype score. Has your mom had this done? It determines both how likely a reoccurrence is and how much one would benefit from chemo.
Best wishes!
yorkie
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Hi Yorkie. Yes, I am very gald that I found this site, it's been helping me alot to be able to cope with all the challenges. Yes, the first oncologist have sent her to onco type test which haven't got the result back yet, but the 2nd oncologist was disagreeing with the onco type test, as he was saying since 1/3 lymph node is positive, she needs to start on 3 different types of chemo after her 2nd surgery, which is very confusing as they have contraindicated ideas!
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Do you know the size, stage and grade of her tumor? These are also factors in the decision. Regarding nodes, I was told that under 4 was not an automatic trigger for chemo.
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