Round#2 My Mother is probably going to have a radical masectomy this time?

My mom was diagnosed with cancer about 6/7 months back.  It was in her left breast (I believe) where the tumor was located.  They labeled her with stage 2 breast cancer w/lymhnodes affected.  She was very positive (over 60%...) for estrogen positive cancer.  She had like 6 out of 10 lymhnodes affected so they removed all the lymphnodes and the lump (she had a lumpectomy).  The Dr's/surgeons said she had enough tissue without having to do a full masectomy at the time.  They did other scans and I know they checked her lungs and liver (they were clear)...no bone scan at this point (I do not think), but they claim she has these micrscopic cells they do not seem to disapear and that is scaring them(the words of the Dr's)..so she had like 5 sessions of chemo (every three weeks) and she completed that approx a month ago.  She went back a week or so ago and they opened the same incision in breast they checked the tissue and nothing hs changed accordingto Dr;s (does not sound like ll details were given yet), but it appears as if it has not shrunk or enlarged (the microscopic cells they could not get rid of the first time).

My mom is going this upcoming week and they (The Dr) will let her know what the options/recc. are).  She (my Mom) is extremely discouraged at this point and does not want to do anymore chemo esp. if it will not help and she has not even had her radiation yet...would it make sense to do a full masectomy and take evrything and then start het on tamoxifen as they said she would eventually do along w/radition for 6/7 weeks?  Do you think some alternative drugs?Help

[CCF-RN,MSN-JS]

Dear reallyconcerned, At the time your mother's cancer was diagnosed it sounds like they did a lumpectomy, found clear margins, and with the lymph node dissection found 6 of 10 positive lymph nodes.  Having a lumpectomy followed by radiation therapy (usually within 6 months of the surgery), has been found to be comparible to mastectomy for local control of the cancer (or the cancer in the breast tissue).  The immediate concern after the surgery though is with 6 of 10 positive lymph nodes that there may be microscopic spread of cancer to another area of the body.  The use of chemotherapy first before completing the local treatment to the breast is to hopefully treat any cancer that may have spread beyond the breast.  

I'm a little confused about the reopening of the incision, and that nothing has changed.  A lumpectomy that had clear margins there would not be any cancer remaining - as far as they could tell.  However now that chemotherapy is complete to treat possible microscopic spread beyond the breast, radiation therapy would still be necessary to treat any possible disease remaining in the breast tissue (this is the choice made in the beginning mastectomy vs. lumpectomy + radiation therapy).  Tamoxifen following radiation would be recommended as your mother's tumor was positive for estrogen receptors, and data shows that 5 years of tamoxifen decreases risk of recurrence and improves overall survival.