I'm so sorry to hear of your diagnosis - no wonder this has been a big shock for you! No wonder either than your head is spinning with all the options. It can be very overwhelming trying to process all of the information.

I'd take a few days to think it over and come up with a list of questions you can put back to your consultant. Can they tell you more about the pros and cons of each of their suggestions and what the implications are?

I can offer my experience of a lymph node clearance and how this came about if it helps. So I was diagnosed with mucinous carcinoma of the breast after having 2 breast biopsies and 1 lymph node biopsy at the breast clinic. All 3 came back with cancer. Because I already had at least 1 lymph node positive, I was recommended to have 2 levels of lymph nodes removed as part of my mastectomy op. (There are 3 levels in total around the breast area, the third level being higher up towards the neckline).

The pathology came back after the op that I had 2 lymph nodes with cancer out of a total of 13 cleared, which is considered a low level of lymph nodes involved overall and was at least some reassurance for me.

This is not a medical explanation, but as I understand it, the lymph nodes are part of the lymph system which is a bit like a super highway around the body for your immune system. Initially a cancer may spread to the nearest lymph nodes in the armpit, but there is also the possibility that it could spread through the lymph system to other parts of the body, posing a risk of the cancer returning after surgery. The more lymph nodes involved, the greater these risks.

If you know you've already got cancer in at least one lymph node, then removal of the lymph nodes will physically remove any cancer contained in others. It also allows the doctors to figure out the extent of your lymph node involvement and hence the most effective treatment.

There is a risk of lymphodema with lymph node removal - this is a build up of lymph fluid in the area as the lymph nodes are no longer present to act as a drain. This is unfortunately a life long risk but there are things you can do to minimise it like not having blood pressure taken from that arm, or injections/blood samples. I'm orering a medical bracelet to wear with this info on it.

I'd also mention that from a recovery point of view, lymph node removal involves cutting some of the nerves in the armpit area, which can create some rather odd pins and needles/jingling and jangling sensations in the arm and some numbness. l can already feel that these pains are working themselves out 2 weeks post-op for me - the nerves do regenerate, so there's no need to panic. Though equally, I don't know if I'll every be quite the same as I was before surgery, though I'm sure we could all say that!

I know it's not easy but I'd just say keep asking questions until you feel you've got the answers you need. I was equally unsure about my options, but a good chat with my surgeon really helped clarify things.

Good luck and keep us posted! x

We are having a debate about chemo. Initially I was told they want to do chemo but my surgeon pointed out that I may be eligible for a genomic test which will determine the likely effectiveness of the different treatments....Chemo is not always as effective for my particular type of cancer. 

As the tests came back strongly positive for the oestrogen receptor though I can expect hormone therapy (same for you I think?).  I think the radio is really an insurance policy as the surgeon explained they can only remove 98% of the breast tissue with surgery so radio zaps anything left behind.

To add, I had no choice over the mastectomy as I had multiple tumours across the breast. It was definitely the right treatment in my case.

lets keep in touch and glad to share experiences xx

Hi, I also had further lymph nodes removed after the initial ones removed showed cancer in one, the other nodes ,fifteen I think came back clear,so I had radiotherapy and tablet that I should have taken for five years but stopped as too many side effects, that was in 2013, that was my choice ,but always difficult when put in front of you, all the very best x