I’m a stage 2 early breast cancer patient . Triple positive . Lump 4mm on detection now reduced down less than 2mm with 4 weeks of taxcel chemo to go ( previously completed r x fortnightly AC chemo). Herceptin Infusions has been weekly 8 weeks , another 4 to go then becomes 3 weekly in 2021 . I’m now at point of having to decide on surgery option. I’ll be clarifying these questions to my surgery team as well .ive been told,I’m a candidate for lumpectomy , and this will require radiation treatment .the question of reconstruction I’ve decided can be left for later ( at present I don’t think I will bother but.....one doesn’t always know till you are really in that situation).it was made clear to me that status of my lymph nodes is almost a separate issue . At present no sign of enlargement on physical,exam or scan or ultrasound . Sentenial lymph nodes will be checked On day of surgery has anyone been in same situation where lymph nodes were found to be cancerous- how many ? did you have wide clearance Of the breast lump with lumpectomy and radiation? ( with clear margins at lumpectomy).What I suppose I’m trying to get my head around is a few issues radiation therapy - it’s been a interesting time with chemo ( that I had to have ) and I’d somehow like to avoid radiation therapy . Q if I opt for mastectomy -can I avoid radiation If lymph nodes clear ? Or if it’s in lymph nodes , they’ll do,a clearance/wide excision will I end up having to have radiation as well Hope that makes sense . I do understand that radiation burns etc do not end up a major issue with everyone but I’m tending to think it’s one less,toxin to impose on my body . Surgery isn’t easy either but......

Just a update - had a lumpectomy on 4th jan 2021. 6 nodes removed and all were non cancerous. Excision margins clear on lesion which had responded well to chemotherapy. Down from 4 cm to hard to find (despite marker) lump,requiring mammogram to insert fine wire prior to surgery. Little dispruption to,symmetry of left breast . I think I’ll be able to wear normal bras once healing complete. Now awaiting radiation treatment to,start, and ongoing three weekly herceptin and I think hormone therapy. Feeling positive about the future. It’s been a long six months. Thank you to those here posting their comments as it helped me immensely

I also used Mepitel during my Radiotherapy for 5 weeks and then until it peeled off afterwards.I had no signs that I had had 25 doses of Radiotherapy. The explanation that I had about how it works, was different than I had thought.Apparently it allows the skin to maintain it's own moisture and not lose it. Also it decreases skin sensitivity and irritation, with it's protective barrier. For theses reasons it is important to have it on 24/7. Even on the weekend.And have it replaced at next Radiotherapy appt. Some times there will be daily patching. My main area lasted 2 1/2 weeks first time applied.

Update as of 26th jan . I ended up going with recommendations as per surgeon. Lumpectomy ,SLN and 6 lymph nodes removed . Best possible outcome ( thank god) in that no cancer in lymph nodes and clear margins around tumour which had shrunk considerably post chemo. I’m very happy with surgical result as very little left breast defect ( apart from the blue dye blobs which may fade over time) . Should be able to,wear normal non underwire bras in a few months. Am to see radiation specialist next week for planning appointment . I appear to,have some cording in armpit but will be seeing lymphodema clinic soon for treatment. Fingers crossed that this treatment pathway kicks the ca to the kerb . Still to,have hormone regime appointment and herceptin will continue until later in 2021

Thanks everyone for your comments . I think I’m resigned to going along with medical recommendations with radiation if it’s warranted ( lumpectomy will,mean I have to,have it anyhow. ) I’m still to decide on whether I’ll,have a mastectomy , but now appreciate if cancer found in lymph nodes with a mastectomy I’m up for radiation as well. At the moment I’ve had 9th dose of taxel,and am battling signs of -web-herald neuropathy . Does 8 and 9 were reduced to 75%. Oncologist trying to,get me to dose 11 but we’ll have to,see how the PN goes each week .

@noosa_blue150 Great news to hear that all has gone well! I too had DCIS 3 years ago & following advice from my surgeon, had a lumpectomy & during the surgery she moved some tissue from under my breast to fill in the gap & now, you wouldn't even know I had surgery! As my margins were clear, the surgeon recommended i only have rad treatment for 3 weeks so I didnt have to have chemo.One piece of advice i would like to share with you is that my oncologist recommended I use Mepitel film during my rad treatment. I know not all patients can have this & some hospitals dont have it. I had my treatment in a private hospital. This clear film protects you from the radiation burn. It covers the treatment area & you keep it on for the entire treatment plus a few weeks after, as that is when the rad is at its peak. You shower with it on but you need to keep it bubble free & make sure it doesnt tear. Every day before my treatment, I would pop in to see the nurse & she would check me out & patch up any film that needed repair work. Yes, it does take a few days to get use to it but eventually I saw it as my protective shield & after my treatment ended & I took it off, I had NO redness, burning or peeling. You wouldnt have even known I had rad treatment. 5 weeks of being wrapped up was totally worth it so you may like to discuss this with your specialist & I know there are other options available to help in this area too. Good luck with your next step & so glad you are progressing well & ticking off those boxes! Sending love, strength & prayers xx

Lumpectomy vs mastectomy and lymph nodes surgery

noosa_blue150
Member
5 years ago
Hmmm that second lot of chemo should read I’ve been having weekly paclitaxel , only 4 to go and herceptin . Herceptin will go to three weekly Infusions on completion of taxel.
Jane221
Member
5 years ago
Hi @noosa_blue150, as @Afraser said, it can depend a lot on a number of factors whether you will need / be advised to have radiation.

I had 2 tumours (1 Invasive lobular tumour, ER & PR+ and 1 ductal tumour, HER2+) and had 1 positive node and so when I had my mastectomy I also had an axilla clearance. I went on to have chemo, Herceptin and radiation and am still on Tamoxifen. I had hoped to avoid radiation but given the size of the lobular tumour and its location close to the chest wall I was advised to have radiation, which I decided to have. That was 8 years ago now.

Best wishes for your remaining treatment. Jane xx
FLClover
Member
5 years ago
Hi @noosa_blue150 I think that if you have clear nodes and a mastectomy, then you won’t need radiation. Especially if you feel like the mastectomy will be enough. At the end of the day the choice is yours. I’m like you, I want to avoid as much poisoning as possible. I had radiation but didn’t have chemo, and also had a double mastectomy. I could’ve also avoided radiation if not for possible issues with mastectomy. Good luck 🍀
PV123
Member
5 years ago
Hi @noosa_blue150

I had a 12mm IDC, her2+ and Er+. I initially had a lumpectomy with sentinel node biopsy. I had clear margins with no affected nodes. After finishing chemo, when I saw the radiologist he mentioned that if I had a mastectomy then I would not need radiation. I chose bilateral mastectomy with no reconstruction. I did not need to have radiation.
I had wanted to have mastectomy in the first instance, however the surgeon felt lumpectomy with radiation would be a better choice.
I had taxol weekly for 12 weeks and 3 weekly herceptin. I wasn’t aware that herceptin could be given weekly as well. Hope you are going well with your treatment and good luck with your surgery.
Afraser
Member
5 years ago
Dear @noosa_blue150

I think it can vary a lot depending on the type of cancer, stage and even surgeon’s preferences (for a good outcome). I wasn’t a candidate for a lumpectomy, had a mastectomy with axillary clearance (one known malignant node but several looking suspicious). Turned out the rest were just play-acting, one only. I didn’t have radiotherapy. I had six months of chemo post surgery. Get some ideas from other by all means but your oncologist (and surgeon) are an important starting point. Best wishes.

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