what further treatment is recommended

[jm40]

I had a lumpectomy for removal of a neuroendocrine carcinoma 1.5.x1.0cm ; estrogen and progeserone receptors were positive 90% nuclear stain.  Left axillary, lymph node dissection showed one of five lymph nodes is positive for micrometastasis on H&E and pancytokeratin immunohistochemical stain.  The surgeon's recommendation was to have mammograms every 6 months and to take either femera or arimiley for 5 years.  Of course, he recommended that I consult an oncologist for a second opinion as to whether or not radiation therapy would be necessary.

My question is, is radiation recommended for the above parameters?

[lizziecee]

Wow - I am amazed that your surgeon is not recommending total axillary resection, chemo as well as radiiotherapy. I live in England and my breast care centre of excellence (one of only 6 in England) always recommends chemo & rads for invasive tumours over 1 cm, and always for lymph node spread. As the nurse said, you really need to see an Oncologist and get proper treatment sorted out now. I would not, for one second, wait for 6 months.  If you already have spread to your lymph nodes, how do they know it has not spread to other organs?

I had a non palpable  invasive ductal tumour, 2 cm, stage 2 and grade 2, with associated DCIS - lumpectomy (WLE), 3/8 lymph nodes positive, so then total axillary removal where one more node was found positive. As I started FEC chemo, I had a nuclear bone scan, chest x-ray and abdominal CT scan of other organs. All thankfully clear. I then had 25 rads with 2 boosters.  Now on Arimidex, but coming up to 5 yrs from dx and don't know what will happen in January.  

I have sadly learned through some 37 yrs of Crohn's disease that no doctor, no matter their speciality, is as concerned about my ongoing health as I am, so I am now very proactive - do my research, and if necessary, demand appropriate tests.

I am doing fine... just waiting for results of an MRI as I have a stricture in my small intestine that probably means resection, but I still wake up each morning with a smile on my face, that I am alive, not in pain or distress from Crohn's. I have found breast cancer so much easier to deal with than Crohn's.

Take care...if I were you I would get another opinion about your future treatment.

Truly, you need to be your best own advocate.....and get the tests you need.
Liz in Cornwall, England.

[Cleveland Clinic]

Dear jm40:  Recommendations for treatment are based on a variety of factors, including size of tumor, the pathologic features, lymph node metastasis, etc.  Without ability to evaluate including review of the pathology slides it is impossible to comment specifically on the recommendations in this case.  Our recommendation would be to see the medical oncologist who can make recommendations based on the details of your situation.