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Standard of care for Radiation to axilla?

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JMJ View Drop Down
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    Posted: Jul 08 2014 at 5:32pm
I had two opinions on radiation, one dr included the axilla in the recommendation one did not. I had three positive nodes, the third was micromets. My tumor was 4.6 cm and my smallest margin less than a mm. The dr that did not recommend radiating the axilla said surgical removal was sufficient treatment for the axilla and the risk of lymphadema was higher with radiating it. I had a total of 22 nodes removed. I am 40 years old. The dr that wanted to radiate the axilla said they have been radiating the axilla for 20 years and doesn't understand why they wouldn't radiate it.

What other considerations should I be looking into?

+JMJ
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123Donna View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Jul 08 2014 at 6:01pm
I would think you'd want to radiate with 3 positive nodes. If you are unsure, maybe another opinion from a major cancer center (NCCN or a teaching hospital)? There's another thread that talks about the benefits of adding radiation therapy. I'll try to bump it up for you to see and look at the research studies posted in the thread.

Donna
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: Jul 08 2014 at 8:03pm
Even with one positive node there is a benefit to irradiating the chest wall.  Of that I'm sure of.  As for the axilla, it does seem like the research coming out supports not irradiating it in general.  Not sure how this applies or not to TNs.   Are you planning on irradiating the chest wall?

Good luck deciding!

-Denise
DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10.
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Annie View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Annie Quote  Post ReplyReply Direct Link To This Post Posted: Jul 09 2014 at 12:58pm



Hi JMJ,   I had radiation of the axilla for 2/5 lymph nodes positive. I am not sorry. I did have some side effects from radiation but consider it to be less than the possibilities of what may have occurred had I not had the radiation.

             Take care and God Bless. Love, Annie
            
Annie TNBC Stage IIA Gr 3 1cm lesion 2/5 lymph nodes+ lumpectomy,FEC & D 30Rads finished(08/2009) BRCA- Chronic Cellulitis due to Radiation-- L.Mastectomy Jan 2012
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Post Options Post Options   Thanks (0) Thanks(0)   Quote JulieKCA2013 Quote  Post ReplyReply Direct Link To This Post Posted: Jul 09 2014 at 10:18pm
I had 4/24 positive nodes at the time of my surgery.  It too scared me when my radiation oncologist said the beam would not be directed at the axilla.  He said the beams would cover much of the axillary area without the direct hit to the axilla, which tends to have the complications with lymphadema.  I was skeptical but he was right.  My radiation burn proved he was right when it covered the bottom half of my armpit.  
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MikkyHarren Quote  Post ReplyReply Direct Link To This Post Posted: Sep 15 2014 at 2:01am
Not sure how this applies or not to TNs.   Are you planning on irradiating the chest wall?
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