Hi there
I had a mx with immediate diep reconstruction on 5th July. Just been back for results. I;m really confused as I had a sentinel node biopsy on 15th June which came back negative yet today I have been told that I need to have chemo and radiotherapy. Am so shocked because I thought if there were no lymph involvement I wouldn’t need chemo?? Has any of you lovely ladies been in the same situation?? Suzie Q
Hi Suzie, yes I had this. I was told that it was an insurance policy really. I was very shocked as I thought I may have to have Radiotherapy, but was upset when I was told I had to have chemo. I have had all my treatment now and I am fine. Has it been explained to you why this is the case?
Hi. I was also node negative but it can also travel through the blood as well. I have tnbc. I had TAX two years ago and now Taxol as its back in bones and lungs. I do hope you will be very different to me, but there is a risk even if you are node negative.
Sadie Xx Xx
Hi Suzie
I had mx and immediate ld flap recon - 15 nodes removed, all negative. I’ve just finished Chemo and will soon start rads.
My understanding is that cancer cells can also get into the bloodstream as well as the lymph system and so the chemo is a ‘belt and braces’ mop up exercise.
If you want to know, when you next see your surgeon/onc you can ask what the numbers are - they run a little computer programme where they plug in all the info about your cancer and get out survival and recurrance stats, and their improvement if you have chemo/hormone therapy, etc.
It may vary from area to area, but I was told that they recommend chemo if it will improve your stats by 3% or more. Despite no node involvement, having chemo and tamoxifen lifts my chances of being here in 10 years time from 75% to 88% - defo worth it!
Good luck
Dx
have you asked to see your path report? that might shed more light on things. one of my tumors had its own blood supply but that waa not an invasive cancer so they wore not bothered about that, my invasive cancer cells had not got their own vascular system which was a huge releif.
Hi Suzie
you said your node biopsy was clear, but were the nodes they removed with surgery ? they weigh up your treatments with lots of factors not just nodes, they take into concideration a number of things … age, size of tumour, Grade & stage if there were good clean margins, if its hormone receptive or triple negative, also if your pre or post menopausal, or going through menopause.
You could call your breast nurse & ask these questions
hope this helps
Mekala x
OAL makes a good point there, you could ask for your path report as there is things on there taken into concideration that we dont really understand but you can go over it with your oncologist, the blood supply mentioned is another thing too, you can be concidered to have clean margins yet this doesn’t mean there was no vessels atached & if there are you need to know if there was any vascular invasion?
Yes, I have.
I had WLE.
No node involvement but as the cancer was Grade 3 and 45mm big, they said that justified doing chemo to zap any errant cells lurking around the body, there can be micro cancer cells that can’t be detected by the lymph nodes, that can lurk then grow and in a few years it could return.
That’s why you need chemo 
I was miffed too, of all the treatment chemo was the one that scared me the most.
I have to say though, although I’ve had loads of SEs, I’d still do it again if I had to for the benefits it gives you.
Nothing upon NOTHING is worth risking your future life really, no matter how bleak.
xxx
And me, had SNB, came back negative, I was shocked to learn I had to have chemo too, but as previous comments… it is an insurance. My Onc said it guards against one tiny little cell travelling through the blood system rather than lymphatic. I had 4 x FEC and 4 x Tax, need to have 25 rads too! My lump was 13mm, clear margins but DCI. I am on Herceptin for a year because mine was HER2+++. Good luck sweetie it’s a shock to start with, but doable, and before you know it… it’s done xx
I was grade 2 with no node involvement but because I was triple negative I had to have chemo and rads-the size of the tumour is significant too.
Vx
Hi Suzie
I had mx and recon a couple of months ago, but I did have nodes involved so knew that chemo would be inevitable. I think you need to ask if there was any vascular invasion. Im not really sure what this means, but after I had my lumpectomy I was told there was vascular invasion, so that is why they recommended i should have a full mx.
Chemo has not been too bad for me at all. I know how scared I was at the start, but it has been nothing like as bad as i feared. They told me they were ‘pretty sure’ all the cancer had gone after the mx, as they didnt find anything else, but that having chemo and rads would be like an extra insurance policy for me.
Are you happy with your reconstructed breast? I was really pleased with what they did for me 
Sending you a hug, Lynne x
Hi Suzie,
I had a micro amount in my sentinel nodes, I was told chemo from the start to be honest before they even knew the pathology due to having up to 8 areas of cancer in 1 breast. But I only found out further down the line that I had lymphovascular invasion which I think means that the cancer had the ability to spread through the blood or create its own bloodstream (someone might be able to correct me on that) so that was the main cause for concern and reasoning behind the chemo decision.
Maybe there was just a number of other factors like the grade etc that lead them to decide to go down the chemo route.
Paula xx
Hi suzie,
I was 36 when diagnosed last march. My sentinel node biopsy was also clear. My tumour was grade 3, " vaguely" oestrogen positive and 17mm in length . I knew from the outset I would have chemo, even after the initial biopsy when they thought it was a grade 2, and a bit smaller. My benefit from chemo was 5% ie. My odds of being here in 10years time were increased by 5% by me having chemo. The oncologist told me that statistics in cases similar to mine showed that 85 out a 100 women would be alive in 10 years if they only had a mastectomy ( or the equivalent of lumpectomy plus radiotherapy) and a further 5 women would be alive because they had chemo.
My understanding is that the usual place breast cancer cells travel first is the lymph nodes, which is why it’s a really good sign that your lymph nodes are clear. However, sometimes tiny micro cancer cells can escape into the bloodstream and escape into your body. At the moment, doctors cannot tell who is at risk of this having happened and therefore they err on the side of caution, particularly with younger women, and give them chemotherapy. Most node negative ladies who have chemo won’t actually have needed it but they can’t tell which do or don’t. Personally, I’d prefer to be in the " didn’t actually need chemo after all but had it anyway" group than the " oh, did need chemo after all but didn’t have it" group.
Being under 50 is young in breast cancer terms and most of us do have chemo. I had 3 fec and 3 tax from April to august last year and it now feels like it happened to somebody else. It was hard going through it but I am mighty glad at this end of it that I did persevere.
All the very best with your treatment,
Vickie
Thanks everyone for your comments xxx