Hello Embop

Its good news that you don't need anymore surgery following clear margins. I had my lumpectomy Oct 4th and with clear margins, clear sentinel node, and 1 out of 3 nodes positive,  so very similar.  I think its fair to say that practice does vary and it was never suggested that I a axillary node clearance. It may depend on where the positive node was, did  they tell you. 

In relation to the chemo,  practice around this also varies depending if yours is esrogoen, progresterone positive or HER2 negative, sorry but i don't know what yours was.  Locally where i live in the south east the main nhs trusts use something called Oncotype DX test which looks to see if the tumours would respond to chemo or not. I had this test done and it showed clearly that I would not benefit from Chemo. Saying that I still felt a bit uneasy with the result and although i didn't want chemo at the same time I didn't want to have the uncertaintly that it may have spread. I am now waiting to start the radio, hopefully before xmas.

The oncotoype test was dealth with by the oncologist so that may be something they discuss with you, good luck with your appointment

xk

Hi, 

My mum has breast cancer, she had a lumpectomy and a sentinal lymph node biopsy which was positive (1/1). It was a difficult decision to make but we decided to do the axillary clearance for 2 main reasons:

1) Peace of mind - knowing we've done everything we can 

2) To help guide future treatment decisions

Like you, we were fairly confident that the other nodes would be clear so we did the axillary clearance but level 1 and 2 lymph nodes only - it's worth asking your consultant about this (our consultant orignally said no and that all 3 levels were neccessary but our surgeon on the day said level 1 and 2 only was possible and that he would actually recommend it) - the risk of lymphodema reduces with this, althought there is still a risk. 

Luckily, the rest of my mums nodes were clear (0/9), this gave us the peace of mind that we needed but also meant that my mum didn't need chemo (if we didn't do the axiallary clearance, then chemo most likely would have been recommended). It does depend on the charecteristics of your tumour however e.g. Her2+ or - etc.

It's defo worth reading more about this - in our family we have a medical student and someone who works in the pharamaceutical industry who helped massively. Here are some links that might help:

www.ncbi.nlm.nih.gov/.../28898379

www.thelancet.com/.../fulltext

I wish you the best of luck!

Hi Embop.

The answer to this question is not always black and white.

I am not a medic, but I think if I was in your shoes I would ask the oncologists what the chances are of a recurrence with, and without, node clearance. The Consultant says she will bet money on it. You need more information in the form of percentages.

You can then balance that out against the chances of possible side effects (the oncologist can give you statistics for that as well) and whether they may be permanent. As I said I am not a medic, but know that the chances of getting lyphodaema, as other people are mentioned in their posts, are important to bear in mind.

Armed with this information, you can then make your own decision. 

Hi, I know this post is a year old but my mum is in literally exactly the same position as you were and unsure what to do. Lumpectomy and one node out of three positive. How did you get on? And did you have chemo? Really hope you're well x

Embob

Hi  Embo. I had three nodes involved  and had all lymoth nodes removed from under my right arm .i did get a seroma, its a build up.of fluids as the nodes aren't there to drain awsy fluid.  It doesn't happen to everyone ,but after having it drained twice  and one infection there its healed up well .it just is your decision to make, but yes do talk to your oncologist, I did mine as was offerd chemotherapy  and radiotherapy as a precautionary measure, I struggled making that decision, but after carefully thinking about it ,I decided to go ahead with it, as my way of thinking was...there is no guarantees if I have chemotherapy  and radiotherapy  that it will  or wont return ,but having it  if it did return I could honestly say I'd done all I could  to try to prevent it coming back, but if I didnt go ahead with it  id always be thinking if it did return, maybe if id have had chemotherapy and radiotherapy it wouldn't off come back. 

Ive just finished my chemotherapy on Monday 14th December, but not yet had the Radiotherapy, but it won't be long coming i guess,don't know how many times or for how long yet .Good luck with your decision. X