Chemo or not?

Hi there. I have had a lumpectomy and sentinel node biopsy. I am having more surgery as they didn't get clear margins and the sentinel node had a macrometastasis of 4mm. This means I'm having an axillary clearance. I understand the reasons for this but there is now some talk of chemo which was never in discussion before. As I only had 1/1 positive lymph node, I think they want to see what else is found in clearance. However I feel extremely anxious about the uncertainty of it all. I like to prepare. I'm getting such good care but I am so scared. 

Is chemo needed for a hormone receptor positive, 20mm, her2- IDC with 1 positive node (so far)?

If they find no more cancer in nodes, will radiotherapy be enough? 

Is 4mm cancer in a lymph node a lot?

Thank you 

  • Hello blue 

    That’s like reading what happened to me but mine was July 22 the outcome for me was no chemo please ask for the oncotyoe DX test this saved me from chemo 

    im here to chat xx. Love Lara x 

  • Thank you Lara. They won't give me oncotype. They said as I'm premenopausal it is not reliable with positive nodes. Did you still have axillary clearance?  

  • Oh they can hun 

    I’m peri I was 48 on diagnosis and I had positive nodes push it I played hell to get it and I had it they changed the rules on oncotyoe a few years ago to include positive nodes x 

  • Yes I had 2 nd operation full aux node clearance that operation went very good other than the drains was quite easy to be fair xx 

  • Thanks Lara. I'm 46. I asked for onco dx but the consultant wasn't shifting. She said if there are any nodes positive there will be a 3% benefit from chemo but if score was over 25, a substantial benefit. She said she would see after results from axillary clearance. These are 6 weeks after surgery so a big wait. Did you have just 1 node positive? I have only had the one sentinel node checked. Hope you're well now x

  • Yes had just one sentil node positive and no mention of chemo until like you after lumpectomy it was like a new diagnosis everything changed , but they don’t like to offer it as it’s expensive I had private insurance they paid it but I no lots who get it on nhs I waited a week after lunpectomy for results then had six node a week later then waited a week for results after that , I had 5 sessions of radio it’s like it never happened now you soon get back to normal and forget it all I promise you lovely xx 

  • The Oncotype results told me chemo would do more harm than good and that tamoxifen and radio was sufficient x 

  • Thanks for your advice. I am glad you escaped chemo. Hopefully I will too. X

  • Hello Blue and thank you for posting,

    I understand you are concerned and the loss of control in a situation is always one of the most difficult things to deal with. Trying to get more information can often feel helpful but it will be difficult to give you an idea of your treatment plan as we are unable to give a medical opinion. However, it isn't unusual for patients who have cancer cells in their lymph nodes to need chemotherapy alongside radiotherapy.

    Until you have the Axilla clearance surgery, they are studied under a microscope and discussed again at MDT then it will be hard for anyone to give you an answer.

    Breast Cancer Now, the UK breast cancer charity, talks about macrometastases on their breast surgery page and we talk about chemotherapy treatments in breast cancer on our website.

    Waiting for news all the time is hard Blue. I hope you are getting support at this time. You may find it helpful to talk things through with one of the nurses on our helpline.  The number to call is Freephone 0808 800 4040 and the lines are open from 9am till 5pm Monday to Friday.

    Take care,

    Sarah.