I’ve had two different opinions about whether I need axillary node clearance before chemo or the other way around. NHS consultant says node clearance then chemo, a private consultant says other way round.
I worry that the NHS view means delaying chemo by many weeks - and surely the chemo will attack the cells in the nodes as well, so at least it won’t be spreading even if the nodes with cancer are still there?
Please can anyone shed any light on whether they had this debate and how it was resolved?
(Background: I have lobular, had mastectomy 2.5 weeks ago, it showed more extensive disease than expected and all six nodes taken out were found to have cells.)
Hi @zelda100 I had chemotherapy before a full axillary clearance. This was the surgeons’ preference as I had a large lymph node tumour, 4cms, and he felt that hopefully shrinking it down a bit with chemo would reduce the difficulty of surgery in a confined space and so the consequent risk of lymphoedema. It shrank to 1.2cms. No lymphoedema. Incidentally, although the lymph node had a good response to the chemo the breast lump showed no response at all, despite being the same tumour
Hi, I am currently having chemo before full axillary clearance. Oncologist’s view was that it was better to go straight ahead with chemo as I have lymph node involvement with extracapsular extension.
My surgeon also felt that the surgery would be an easier surgery post chemo for me and for them. I finish chemo in early October and expect to have the clearance in mid November.
Hi there i also have lobular cancer. I had mammoplasty 4 weeks ago and the post surgery histology revealed a much larger tumour than expected plus all 3 sentinel nodes were positive which was a shock as all pre op radiology had shown normal axilla. I was told I needed a staging CT which ive waiting on results for (extremely anxiously) and then full clearance followed by chemo
Hi Tinkerbell4,
Thank you so much for sharing this. Have they told you why clearance first, then chemo? I’ve spoken with a new oncologist now and she also agrees with chemo first then clearance, in my case. I still can’t get an answer from NHS team about why they want it the other way round.
BTW it does seem like lobular cancers are grossly underestimated by mammograms and ultrasound. After my mastectomy my biggest area was more than double the estimate, and even bigger than the breast MRI suggested (that I had done privately before mastectomy to check for it in other breast). It was also not found at all in a mammogram and ultrasound 11 months previously. I don’t know why this fallibility is not flagged up very heavily after all mammogram ‘all clears’ …
