Hi Sjan - I appreciate your dilemma but I don't think it is essential that you take the decision now. Many oncologists now follow the protocol that if there is a positive lymph node(s), then you start chemo immediately and go back later to do a full surgical ANC if required. Thus I think you could start chemo now and have ANC later if you wanted it - ask your Onc about whether this is an option for you? I don't know whether the fact that you will be on Herceptin for a year will make any difference (I didn't need it). I had surgery to remove rest of my lymph nodes after chemo and I would note that the pathology report showed that the chemo did not kill any of the cancer cells in my lymph nodes, only the ones in my breast!! My Onc then said that for oestrogen positive cancers the chemo often doesn't work well in lymph nodes ... So v glad now I had them out although I very much didn't want to. However, since your positive node tumour was small, your medical team may feel that any further tumours in your lymph nodes would be small enough to respond to chemo and/or radio. But it may be that you can get a second opinion on that at a later date if you start chemo immediately. Best wishes xx
Hi personally I would not take the risk of leaving lymph nodes in that may cause a problem down the line. I have lymphoedema but do not regret having my lymp nodes removed. If I was in your position I would have them out but it is your decision. I recently had a small recurrence in a lymph node in chest 5 years after diagnosis. I was very lucky it got spotted as it was removed. Also I'm sure you realise even if you have lymph nodes removed it does not guarantee that you will develop lymphoedema. You can cope and live with it as many ladies do and I would prefer to be alive with lymphoedema than not.