Will I Benefit From Radiation

I am 35 years old and was diagnosed as having StageIIB cancer after a Modified Radical Mastectomy on Dec 17th.  During the surgery, they removed 19 nodes out of which 2 were positive.  I am currently undergoing the AC chemotherapy regiment which includes a treatment every 21 days for 4 treatments.  I am still waiting on my pathology report to come back to see if my cancer was estrogen receptive/negative.  My oncologist says that I should have radiation therapy immediately following chemo, but my surgeon and my plastic surgeon (had reconstruction done during same surgery with a saline implant) both say it won't benefit me.  They said that there are no studies that show radiation therapy will be beneficial to me since I had only 2 positive nodes.  Please give me your thoughts on this so that I can try to make an educated decision.

[CCF-RN,MSN-JS]

Dear Kimber, Current research has shown superior tumor control and overall survival rates with the addition of post-mastectomy radiation therapy, for women at high risk for tumor recurrence.  This high risk group includes women with four or more positive nodes or an advanced primary tumor.  In the same analysis of the data there was also noted a higher risk of arm swelling (lymphedema).  At this time, the role of post-mastectomy radiation therapy for women with one to three positive lymph nodes remains uncertain and is being examined in a randomized clinical trial.

Radiation therapy if given should not be given at the same time as the chemotherapy and should be delivered within the first 6 months following mastectomy.

This information is from the National Institute of Health Consensus Statement regarding adjuvant therapy for breast cancer, December 2000.

Continue your discussions with your oncologist so that you can weight the risks and benefits that are specific to your case.