[agness]

Here's another idea, in the past 18 months the standard of care has shifted from full Axillary lymph node dissection to sentinal node dissection (SND) based on a large body of evidence that hacking up women's armpits wasn't affecting survival at all and they were causing a lot of lymphedema. I only had a SND because I pushed for less surgery.

After my lumpectomy and SND revealed no disease SND I was told I was NED I was still pushed to get rads. Since I have kids and there isn't really data or studies to the contrary (women who decline don't get tracked or count in oncology most often) I decided to do proton therapy and cause the least amount of damage possible to my body. The tsdiation oncologist refused to do less and so healthy areas of my breast and chest wall were included ("I doubt you will find anyone willing to do less")

I think that any HER2 patient who has a PCR to neoadjuvant treatment should be able to skip rads. The bigger issue for our disease is brain mets. If you don't have a PCR then definately proceed with rads.