Help , I need your advice

[Lani]

http://www.breastcancerupdate.com/do...08_Peto_02.mp3

Did you have any incision or dissection in your armpit? Is there a separate part of the operative report about an axillary dissection?

If no lymph nodes were sampled (removed) they have no way of knowing how many were involved (it is not possible to tell by feeling the lymph nodes with any certainty that they are not involved). PMRT is recommended for those with four or more involved axillary lymph nodes and there is controversy regarding PMRT for those wih 1-3, but no controversy regarding those with none. However, unless there is a separate operative report for your axillary dissection you do not know that your lymph nodes were not involved.

If they did not sample and remove your axillary (armpit) lymph nodes to know they were not involved AND they think your tumor was close to the posterior margin I assume that means the posterior margin was close to the chest wall.

I have usually heard 2mm discussed as being margins that differentiate between adequate margins (>2mm) and inadequate (<2mm), requiring reexcision if possible and/or radiation therapy. 0.7 cm translates as 7mm
Is there any way for you to get a second opinion? Does your surgeon only do breast surgery or does he/she do all general surgery?

Could the radiation therapist suggest someone else for you to consult?

The articles above discuss your being in the group more likely to have a reduced incidence of local recurrence due to radiation therapy ie, your age group and the lymphatic invasion but LESS likely to have radiation therapy provide any benefit with respect to distal recurrence. Since you have already had your breast removed, it is not as if there is a lot left to remove in case of local recurrence without an increased chance of causing some deformity (again, this is just from my readings/going to conferences-- I am not a breast surgeon or even a nurse).

How about seeking out resources using your Kenyan website? Perhaps someone can help you find a second opinion and/or LINAC radiation therapy.

Best of luck!

[Lani]

Will try to check in, but may not be able to

Hope the info helps with your decision!
PS the question about the inner quadrant--if that is where your tumor was, it is more likely the int mammary lymph node was involved which MIGHT make you think more about radiation therapy

[Lani]

hope the information was helpful!

Lani

[Lani]

Anything to report?

[Lani]

Chrisy--any news?

[christie]

hi Lani,

thanks for all the information, i will be meeting my radiologist next week as she has gone to South africa. I hope she will be able to give me a clear picture whether i actually need radiation. please keep praying , as i am very nervous about this whole issue.