Stage IIIA

I was diagnosed with IDC, 6 x 7 cm tumor, hormone positive (both 90%), grade 2, had neoadjuvant chemo which reduced tumor to 3 x 4.5 cm, double mastectomy, and 33 radiation treatments with BOLUS and 7 boosts.  Prior to surgery I had a SNB.  Five nodes were removed, four were positive.  My official stage is IIIA.  During surgery my surgeon removed a large area of tissue that should have contained lymph nodes.  After surgery he said no nodes were found.  He said it was highly unlikely that I didn't have any nodes in that area, and felt they were not found due to scar tissue from previous SNB.  Is this normal?  I'm scared to death of recurrence.

[Cleveland Clinic]

Dear dlt10960:  Without knowing exactly what was removed with the SNB and what was removed in the surgical procedure, it is impossible to comment on whether this may be an expected result.  This is a surgical question that could best be answered by the surgeon.  You may want to have a discussion with a radiation oncologist regarding whether there would be a role for this in the prevention of local recurrence.  Regardless, additional axillary lymph nodes would not upstage your cancer and therefore would not impact your risk of recurrence.