Question about lymph nodes and chemotherapy

Hi, I had a mastectomy recently with lymph node clearance. I’ve just found out that chemotherapy is now recommended (wasn’t expecting that) , and that it’s the norm as a preventative measure. However, I’m now thinking what was the point in having the lymph node clearance with the subsequent discomfort and movement problems if I have to have chemo anyway? In my case two lymph nodes were found out of 6 that were cancerous, so I had all the rest removed at the same time as my mastectomy in case of the risk of there being any more. But wouldn’t chemo have cleared away any others if I had not had them removed?
Sorry if this seems like a silly question. I’m a bit phased at having to go through chemo. Any information about this would be appreciated.

Hi Helm,

I have put for you below the link to BCC’s publication with regard to chemotherapy for breast cancer, I hope you find it helpful. If you would like to talk to someone in confidence about this, please don’t hesitate to give our helpline a ring, they’re here to support you. Calls are free, 0808 800 6000 lines open Mon-Fri 9-5 and Sat 10-2

Take care,

Jo, Facilitator

Hi Helm I have recently had a mastectomy. I had chemotherapy prior to all my surgery - six cycles FEC-T- to try and shrink the tumour prior to a WLE. The WLE did not achieve clear margins so subsequently I had an mx. I also had full axilla clearance when I had the WLE, as a FNA found at least 2 lymph nodes with micromets in.
Chemotherapy is often given to “mop up” any other traces of cancer which may or may not be circulating through your bloodstream or which may have moved through your lymphatic system prior to diagnosis. My understanding (although I am not a medical person) is that chemotherapy is offered to ladies dependent on (a) age at diagnosis (the younger you are the higher the chance of chemo) (b) the stage and grade of the cancer - i.e. is it Grade 2 or 3? If it has spread to lymph nodes you are also probably Stage 2 which again would probably meet the criteria for chemotherapy and (c) Is it hormone receptor positive - if you are triple negative then chemo is usually offered. If you are HEr2 positive you would be offered Herceptin, and again it is my understanding this is usually offered alongside chemo. So I guess the best thing is to ask your oncologist why he / she is recommending chemotherapy, what criteria do you meet and also how much difference to your longterm prognosis do they think the chemo would make (there is a tool avaiable from the NHS - here is the link - - called Predict which I think is used to determine whether chemotherapy would be of benefit or not.)
I understand how you feel re: the lymph node clearance. This is often more invasive and unpleasant than the mastectomy. However, most hospitals have a protocol to remove all lymph nodes if 4 or more have cancer cells in them.
I was dreading chemo. But it wasn’t half as bad as I thought it would be (to be honest I hvae found the surgeries rougher) and it is doable. There are some good tips on here and lots of us ladies have had chemo and come through it. It isn’t pleasant. But you can get through it. To be honest, given all that I know now, I am glad I had it as I want everyting thrown at my cancer to give me the best shot of survival. I hope your oncologist can give you the information that you need and you will get some advice too from this forum if you need it. Good luck with the next phase in your treatment plan. It isn’t great but it is doable. Emma x

Hi, thanks very much for your replies. I think chemo is probably best for prevention, so I’ll go through with it. I think I’m more nervous about it than having the mastectomy and lymph node removal. But, as spookymoo says, it probably won’t be as bad as I think (I hope!) - most things aren’t usually.

Hi, I’m new and was wondering why I’ve been told I have to have ANC after an mx where two nodes were found to have cancer cells, as I’m also going to have chemotherapy. Wouldn’t the chemo kill the cells in the remaining nodes?
I’m really reluctant to have the ANC as I dread lymphodoema and loss of mobility in my arm if it could be avoided. I wasn’t told anything about micromets etc. and the consultant just said it was quite possible no cancer cells would be found in the additional nodes they CN just said it was standard procedure!