Does two positive sentinel nodes equate to certain chemo?

LisaO

Unfortunately Im new to this group.
On the 1st June I had a total right mastectomy to remove 2 areas of cancer,one 1.5cm the other micro. I opted for no reconstruction.  My biopsy showed 2 positive nodes (if my terminology is right...as Im learning, they were micro).
On the 15th June I then had an auxillary clearance which came back clear.
On my second visit to the surgeon I was told that I would have "choices" in my treatment and that chemo may be off the table due to the low % of benefit, however hormone treatment would most certainly be on the table as my results showed that this would most definately be of benefit due to my report.  Being told that I would have "choices" was the most positive thing I have been told through this journey as I have had no choices up to this point.  However I cant help but "google" prior to my oncologist appointment on the 4th July and very limited information is available.
I know each and every diagnosis is individual and treatment is also individual, but input on similar positions as myself would be appreciated.
 

iserbrown

Hi Lisa googling isn't always fruitful.  It does your head in. When you visit the Oncologist choices will be offered. It comes to what is best for you. We're all different in options offered due to pathology results ongoing health issues et cetera 
Try not to stress. Yeah I know easier said than done 
If you have someone with you for the appointment it helps 
Take care 

nikkid

Hi, my girlfriend had 2/4 sentinel nodes positive - had radio and no chemo. Everyone is different. X

Molly001

As you say @Lisao it really is so individual and 'options' offered you will be based on risk vs benefit for your individual circumstance for each treatment. It's really hard waiting for all the info. I know the thought of chemo is scary, but if it's offered, like most of us you will probably want to do it to give yourself the best chance of beating this thing. Try not to waste worry for now about the unknown. You will feel better once your treatment plan is in place, whatever it may be. Once you know what you're in for it's much easier to focus on getting through it one step at a time. And you will get through it. Waiting is the hardest part. Hope you get your answers soon... and stay away from dr google, no good.

Afraser

Divorce Dr Google, no friend of yours! We all know how hard waiting is but your oncologist is best placed to know the ins and outs of your particular case. You may still have choices, but sensible ones that will take you forward. Best wishes

primek

I believe 3 and under is not a definite for chemo. Your oncologist will be able to advise which is the best treatment for your particular cancer pathology. Kath x

Unicornkisses

So sorry to see you here, @LisaO.
it seems to depend on the surgeon and the oncologist team whether chemo is required.
My surgeon told me that if any Lymphnode was involved, then it was automatically chemotherapy.
They only took two sentinel nodes during my lumpectomy and 1 was positive, so I was booked for chemo.
I suppose it will also depend on the nature of your cancer too, whether it will respond favourably to chemo.
If you have a choice, then you will probably want to know more about how likely the chemo will change the outcome.
That will mean you will need to understand how the proposed chemo will work. Your Oncologist should be able to explain all that to you. Take notes.
You are entitled to get copies of the pathology reports from any biopsies or pathology you have done, and understanding the jargon they use to stage and grade your cancer will help you to understand when they tell you why or how chemo should help you. 

Your surgeons office should be able to supply these to you.

I understand that a faster growing cancer will respond better than a slower growing one, but you will have to confirm that and which one yours is.
If you are undecided lots of questions to your team are needed.

Your Oncologist will have access to your pathology reports and to various charts and graphs he can show you that will help with describing the amount of benefit you should get.
This can include estimates of recurrence etc
This can be overwhelming, it helps to scribble notes and to ask him to clarify key points.

The Oncologist may also give you choices of chemo treatments, and should run through with you the advantages and drawbacks of each.
I had a choice of 3 but as we ran through them 1 really only suited me, partly because of a family history of heart problems.
When I mentioned this he organised for me to go for an Echocardiogram.
I think he really had already decided this would be the best but wanted to involve me in the decision and ultimately it was my decision.
Your individual cancer will determine whether chemo will help.

I have had chemo, and have just finished.
I actually think it was easier to be told it was necessary than to have to make yet another decision where I worried about making the right one.

However, I think I would have decided to have anything they told me might be beneficial, I am determined to do everything possible to cure this thing.

 I still have to have a mastectomy as my pathology was different after lumpectomy than expected.
But don't know about radiation until after mastectomy pathology comes back.
I will also go on Hormone therapy as my cancer is hormone positive and HER -ve too.

57Pauline

Hi Lisa,
I agree wholeheartedly with comments made so far about the individuality of every case.
I had a double mastectomy in Nov 15 after a routine Breastscreen checkup detected something in my right breast. Initially a lumpectomy suggested but then further micro cells detected, so mastectomy recommended. Then a spot found in my left breast so I requested to have that off as well, rather than just a lumpectomy on left. Like you, I chose to not have reconstruction.  My breast surgeon said that nodes were all clear.
It was only when I had my oncology appointment a few weeks later that I was made aware of micro cells in one node on the right side. I had gone to this appointment expecting a discussion about my follow up hormone treatment but was given the option of chemo. Whoa - what? How could I possibly make that decision?? Just tell me what to do!!!!  We agreed that I'd have a few days to think about it.  To be honest, I found this decision to be the most difficult experience of the whole breast cancer saga, feeling highly unqualified to make that call.  However, the fact that my oncologist, whom I saw as the expert, was giving me the choice suggested to me that my own mental attitude was a determining factor. She supported this view. I chose to not have the chemo. For me, I feel this was the right decision but understand that others might have made the other choice.
I wish you well for your upcoming appointment and hope you find the answer that sits best with you.
Pauline xx

melclarity

@LisaO its not just based on the nodes in regards to chemo, more the grade of your tumor that determines chemo. So lots of factors and only a clear answer from pathology reports in terms of % benefit, so you may not have to. This is where you really rely on their expertise and recommendation for treatment. Deep breath and take it in your stride. xx Melinda 

Brenda5

After the pathology all the specialists get together to plan whats next after surgery. The oncology is a big part of that and you can sit down and discuss all the pro's and con's and a plan of action. Same with the radiologist so take your lists of questions to each appointment.