Hi All
I have got another couple of questions for you wise people. Why , in order to find out if your lymph nodes are affected, do some people (like me) have them removed, some have a sentinel node biopsy, and others have an ultrasound? Are all these methods equally reliable or is one more accurate than the others.
Also why are we all having different chemotherapy regimes. I had 6 x Epirubicin and cyclophosphomide, some seem to be having FEC which I understand to be the two drugs I had and another one as well, and some seem to be 4 x epirubicin followed by 4 x cyclophosphomide and others seem to be having something called Tax? What’s that all about?
Best wishes
Dawne
Hi Dawne
I am not too wise with the above as I was only dx in Jan but I know why I had my lymph nodes out. One was swollen under my arm and they put a needle into it and submitted the fluid that was taken. Sure enough it had cancer in it. They decided to take them all out as they needed to know how far up the “ladder” of nodes the cancer had gone. I also had a grade 3 cancer so perhaps that influenced them. I had mastectomy and axillary clearance in Feb. The results were 2 out of 13 nodes had cancer cells. This result plus tumour then tells them what treatment, ie. chemo.
I am on the TACT2 trial for chemo and thats where my knowledge ends…I also wonder why different chemo in different areas. A girl 10yrs younger than me with same tumour and only 1 node infected had 4x fec and then 4x tax…as to why she had different who knows.
Anyway my toddler has woken best go…good luck with the answers plenty of wise ladies on here with the “knowledge”!!
best wishes
P
Hi Dawne, only some areas of the country do SNB as far as I am aware. If they don’t think there is any cancer in armpit area ( a lump would be there) you may be offered a SNB, like me, the day of my mastectomy. Sadly there was cancer in one node for me so I had to have them all removed 6 weeks later. The SNB is a better procedure as they only take 3 or 4 nodes at the time, and for 75% of ladies they are clear, so it reduces the risk of lymphodema occuring, as you are still left with some nodes for “drainage”. Lymphodema can occur when lack of drainage causes swelling in arm, hand or fingers, and it can be permanant. Hope this makes sense! Until 2 years ago ladies had all nodes removed, SNB is new.
On the subject of chemo, I’m having 6 FEC. There are a lot of regimes and trials too, where tablets are invloved so it’s quite complex. It depends on the individual. Tax is taxotere, my 2 friends are having 3 of that after 3 FEC, but their cancer is grade 3, mine is a two.
Hope this helps!
Liz x
Hi Dawne
As Liz says, it appears that only particular areas of UK carry out SNB currently.
With regard to the chemo regime - this is dependant on several factors - tumour grade/stage, age, lymph involvement etc. Cancer research have some very good info on planning chemo and how onc’s decide which regime to use cancerhelp.org.uk/help/default.asp?page=3336
I had Grade 3, stage 2 tumour with 5/11 lymph nodes involved and her2+ - and I am on 4 x fec, rads, 4 x tax and herceptin
Hope this helps
Margaret x
Hi Dawne - yes, it is a bit of a minefield and confusing when we are first diagnosed. After my 3 step procedure (with a non palpable tumour - this was found on my 3rd mammo) the Radiologist gave me the choice of a mastectomy and no rads, or a WLE and rads, plus “sample node removal”. I had no lump under my arm and I had never heard of lymph nodes - the bc nurse showed me a diagram. They took 8 nodes when doing the WLE as SNB was not available at my hospital then, although I believe it is now. , 3 were malignant so I went back a month later when the wound had healed for total axillary resection. One more node out of a total 18, was malignant.
This was when chemo was first mentioned and quite a shock. I hadn’t found this site then and was quite ignorant about bc. I was just “told” I would have 6 x FEC, then 25 rads. I didn’t think to question the Oncologist, because I didn’t know the first thing about chemo. I guess they make the decision on the pathology reports (do get them, although they read like a foreign language at first) - I had a stage and grade 2, 2 cm invasive ductal tumour with associated intermediate DCIS. I did question why both chemo and rads and was told the rads were to mop up any microscopic malignant cells in the breast, the chemo to mop up any stray cells that may have gone through the lymph system to distant organs. That made sense to me, and I had the chemo and rads. I am 5 yrs since dx and NED now (no evidence of disease).
I am not sure if the taxane chemo drugs were available at my hospital 5 yrs ago, but as I knew zilch, just went with what the Onc prescribed, figuring he knew more than me. Sometimes you just have to have blind faith in your doctors.
Some of the ladies on here (JaneRA, ChristineMH, DawnHC and Mole come to mind) are very knowledgeable and may be able to answer your questions better than me. Guess you could always ask your Oncologist.
Take care,
Liz.
Liz,
Taxanes would not have been available for primary cancer treatment five years ago. They were still the subject of a trial at that time.
My core biopsy came back as clear so technically my surgeon should only have taken my lump and not any nodes … however he was convinced on the other evidence presented (mammo and ultrasound etc) that the lump was cancer so said that he would see how accessible my nodes were during surgery and take the decision from there. He was hoping to get 4 but in fact managed to capture 7. Glad he made the decision to take them during surgery as my lump was tested and confirmed grade 1 tumour so I would most likely have been needed to go back in for a 2nd op if he’d only taken the lump. I was lucky that there was no node involvement in my case so I escaped Chemo but was signed up for 29 rads (25 plus 4 boosters) and tamoxifen for 5 years.
Every case is different, surgery seems to depend on the surgeon and the health authority in your area and each treatment plan is individual to the specific patient.
Thanks for all your help.
Best wishes
Dawne