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
