My dilema any thoughts please.

I am a breast cup cancer which means they can only assume im breast cancer as they cant find the primary source of my cancer.Only the secondary which was isolated to the axillary nodes. Im early stage breast cancer stage 2.
Im having FEC and T with herceptin, on completion they intend to take the nodes but are arguing about whether i should lose my breast. I dont care about the breast that much as im not a girly sort of lady but dont want unecessary surgery.
My oncologist top man Professor says take the breast in case its so tiny its still there and you may be cured but if it comes back it could be nasty because there is no breast for it to go to. He would hope by removing it im cured.
The surgeon doesnt think its necessary.
Second opinion from The Royal Marsden says it isnt necessary but im at a real risk of reoccurence in the breast if it isnt treated with radiotherapy.
Now radiotherapy is on the cards as well.
The dilema is that they are making it my choice and its so hard, ive had all the scans possible and they still cant find cancer anywhere other than the nodes which shrunk after the first treatment and they they think when they remove the nodes there will not be a trace of cancer cells to be found. The Royal Marsdens opinion was it may not even be necessary to remove the nodes but as a general rule they would advise it. What a dilema all the choices are mine and CUP cancer of unknown primary is a dilema in its self.
Any thoughts would be welcome.

Hi Hatty,
Think you and I are obviously both early risers.
I am really sorry. This whole thing is so hard, without being faced with the sort of dilemma you are being faced with. When people have expressed concern or sympathy that I will lose my breast with a mastectomy, I have said that I am actually relieved- to not have been offered a choice. It is very clear what needs to be done to give me the best possible outcome.
I can only comment on how I would personally feel. I am 41, with a young family, and for me I would feel that I had to ere on the side of caution, balancing this of course, with the risks of surgery. So, for me, I would probably want the mastectomy.
One of the things that people seem to find the hardest is moving on from treatment, and getting on with their lives. I think that whilst I might always wonder if I had ‘put myself’ through something unnecessary, I would prefer that to constantly worrying, checking, being paranoid, and ultimately perhaps blaming myself if the worst were to happen, and the BC came back.
Sorry if this reply comes across as ‘all about me,’ (am just re reading it), I wanted to respond to your thread, but feel it is so personal.

I wish you all the best in your treatment. I’m sure you will manage to come to a decision that is right for you,

thank you and any person can only reply with a personal opinion on something like this. My worry is if i have the breast removed and it comes back where does it go. The royal marsden say leave the breast if it comes back its in the breast and remove it grrrrr its so hard.

Ah. That adds another whole dimension to it.
Anyone else’s opinion you can get? I am presuming you kind of have all the top people there anyway though?

Hi Hatty

I have every sympathy. What a horrible decision to have to make.

I had to make the same decision last summer. In my case, the cancer in my nodes was a recurrence but there was no sign of any cancer in the breast. I had various scans, although not all available as I was pregnant at the time so there were some I couldn’t have. Nothing showed up.

I was told a mastectomy would be risk-reducing. No one said anything at the time about the cancer manifesting elsewhere. No one said anything about radiation to the chest wall either, just that if I decided against the mx, I should have radiation to the breast.

I chose to have a mx. Pathology showed there was no cancer in the breast. I have to say that I am pretty gutted, but I still feel it was the right decision. I’ve now been told that I need radiation to the chest wall to reduce the risk of recurrence in the nodes under the ribs and all the way up to the collar bone. Plus under the arm.

I don’t have any advice to offer, I’m sorry to say, only wanted to share my experience as it sounds similar in some ways.

One question: can a primary breast cancer show itself in the nodes only? Is it possible that there is no other cancer in your body?


Yes it can but it does mean there has been a cancer in your body, it has either left your body via digestive system or its still there and even an mri cant pick it up. They think the cancer has disseminated much earlier than other cancers. They are giving me chemo first to use the nodes as a tumour marker and to make sure i responded to treatment which im pleased to say I am.
I am sorry to hear of your dillema, remember to ask for a second opinion and you are entitled to a written opinion from the Royal Marsden if you cant get there just ask your oncologist to write to them. I am an up front person so i research everything and tend to look after my own treatment. I will argue my corner and have received better treatment for it. To date i have seen 4 oncologist before i settled with the Professor. They are doing everything possible to prevent a reaccurence and they call it there buckle and belt approach.
Hope thats of some help.
one other thing even though they dont find it on examination after mx doesnt mean its not there.
Your baby is beautiful.