Collarbone (supraclavicular lymph nodes) radiation

Going through breast cancer treatment Radiotherapy
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Hello everyone,

Since being diagnosed with breast cancer in October 2025, I have used this forum to read about other people’s stories and experiences. It has been a great source of support and reassurance throughout this difficult time.

As I am now coming towards the end of my treatment, I have a dilemma that I am hoping others may be able to share their experiences with.

I was originally diagnosed with two Grade 3, hormone-positive, HER2-negative tumours in my right breast, with one affected lymph node. I had neoadjuvant chemotherapy (12 weekly sessions of paclitaxel followed by 4 EC treatments).

I chose to have a full mastectomy because I was concerned about the risk of recurrence, and I was also advised to have a full lymph node clearance. I had both surgeries in May.

Unfortunately, my final pathology report showed that chemotherapy did to fully kill the cancer in both the breast and lymph node, although what was left was now Grade 2. The report confirmed that only one lymph node was affected and I had 26 removed.

Following surgery, I developed lymphoedema in my right arm and hand. Unfortunately, this has still not fully settled.

I have now been offered radiotherapy to the chest wall and the supraclavicular lymph nodes (the lymph nodes above the collarbone).

I am happy to proceed with the chest wall radiotherapy, but I am feeling very unsure about having the supraclavicular area treated. I have been told that this can carry an increased risk of lung damage, and this particularly concerns me as I already have asthma and scarring on my left lung from previous pneumonia.

I am also worried about the possibility of making my existing lymphoedema worse.

I would really appreciate hearing from anyone who has had radiotherapy to the supraclavicular lymph nodes and if they had any long-term effects?

Thank you so much in advance for sharing your experiences

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Hi there, I had this two years ago after my mastectomy.

Bearing in mind I only had a targetted lymph node dissection (3 nodes taken) including the one that they knew was positive before I had chemo (a similar regime like you, before surgery). So luckily I probably have a lower risk for lymphoedema.

However, I too was a bit alarmed when I saw the diagram of how far up my neck they were proposing to irradiate, but it was absolutely fine. On balance I think it was a good idea, Although I was fortunate to get pathological complete response at surgery, the initial MRI scans suggested there might have been the outside chance of more nodal involvement higher up. Or maybe they were just being ultra-cautious. As a bit of background, my husband was a radiologist - not breast - at the same hospital so every scan report seemed to contain exquisite detail and nuance! At the time that just ramped up my anxiety, now I realise they just wanted to do their best for a colleague….

I also have lung scarring from teenage pneumonia but haven’t noticed any drop off in lung function (and I’m a singer so these things matter!). I guess I was more worried about any heart effects, as I was also on Phesgo at the time (HER 2 +++) and that can have negative effects on heart function. The subsequant heart scans for Phesgo monitoring over the next 9 months showed that was fine too.

I hope my experience helps, but I don’t need to tell you that everyone is different, and it must be a tough choice. Wishing you all the best whatever you decide.

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Hi Sopranosam

I am glad to hear this was the right decision for you and you haven’t had any drop in lung function, and your most recent heart scan was fine.

I can fully understand how this would have worried you being a singer, I am an avid knitter and it’s a worry when sometimes these treatments can risk our ability to do a hobby. Especially as these hobbies can also be good for our mental wellbeing.

Thank you so much for taking the time to reply, I really appreciate it. X

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Hi

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Sorry, clicked the wrong button! Hi I had Collarbone (supraclavicular lymph nodes) radiation ten years ago and have not had any problems. As I had 8 positive lymph nodes I wasn’t given any choice, but in the end I feel it was definitely worth it.