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one lymph node positive - no futher surgery according to my surgeon but radiation

A MyBCTeam Member asked a question 💭
Ontario Canada

Had 2 lumpectomies r side and left r side Ductus CA with all margins clear - Left side tumour 2,2cm all margins clear 3 lymph nodes removed and one had cancer Surgeon suggested no more surgery but radiation on auxilla and both breasts.
On herceptin tumour HER 2 positive. Is this good tretament? Chance of spread and prognosis.

April 2
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A MyBCTeam Member

Hi Annabelle, my diagnosis at 62 was IDC, Stage 2, Grade 3 with one tumor 2.7 cm. but clear lymph nodes (they took three). I had surgery first, then chemo (which included Herceptin) and then the targeted therapy (Herceptin). The protocols are long, it took a little over a year to complete, but the targeted drugs are very effective. I am now 6 years out of treatment and so far, so good! Reach out anytime with questions! Hugs!

April 2
MyBCTeam

Is your treatment plan appropriate with one positive lymph node, clear margins, and HER2-positive breast cancer?

Your treatment plan sounds consistent with standard care for your situation. Since you had lumpectomies with clear margins and only one positive lymph node, your surgeon's recommendation to proceed with Show Full Answer

Is your treatment plan appropriate with one positive lymph node, clear margins, and HER2-positive breast cancer?

Your treatment plan sounds consistent with standard care for your situation. Since you had lumpectomies with clear margins and only one positive lymph node, your surgeon's recommendation to proceed with radiation rather than additional surgery aligns with typical treatment approaches.

Radiation therapy to both breasts and the axilla (underarm area) is commonly recommended after lumpectomy to reduce the risk of cancer returning. This is especially important when lymph nodes are involved, as radiation can target any remaining cancer cells in those areas.

For HER2-positive breast cancer, targeted therapy like Herceptin is a crucial part of treatment. HER2-positive cancers tend to grow faster, but they respond very well to targeted therapies that specifically attack cells with the HER2 protein. Combining targeted therapy with surgery and radiation has been shown to be an effective treatment strategy.

You may also receive chemotherapy along with Herceptin, as this combination is often used for HER2-positive breast cancer. If your cancer is also hormone receptor-positive, hormone therapy might be recommended as well. Regarding prognosis and spread risk: HER2-positive breast cancer can spread more quickly than some other types, which is why the positive lymph node is being addressed with radiation. However, survival rates for early-stage HER2-positive breast cancer have improved dramatically with targeted therapies.

The combination of complete tumor removal (clear margins), targeted therapy, and radiation significantly reduces the chance of recurrence. Your healthcare team will likely monitor you closely with follow-up appointments and may recommend maintenance therapy to further lower the risk of cancer returning.

It's important to discuss any concerns about your specific prognosis with your oncologist, as they can provide personalized information based on all aspects of your diagnosis and overall health.

April 2

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