radiation after masectomy w/ nodes

I was diagnosed with stage 2b breast cancer. I had a masectomy. ER+, 12/14 nodes positive. I underwent AC and taxotere chemo regimens. I am now in radiation. The radiation ononcologist is targeting the superclav area, the chest wall and the scar tissue. My question is why he doesn't target the axillary node dissection sight? I asked him this question and he just gave me an answer that it was not typicaly done. I stated that the dissection was only a sampling of nodes and with so many nodes positive, why would he not target the dissection sight also. What is your experience with this issue? Should I get another opinion or is this a protocol issue?

[CCF-RN,MSN-JS]

Dear kmom, The use of radiation therapy is to try to prevent local recurrence (cancer coming back at the original site).  When planning the radiation therapy all attempts are made to target the area of greatest concern for possible recurrence while protecting normal areas.  If it can be, radiation therapy to the axillary area is generally avoided.  This is because radiation to this area can increase the risk of lymphedema.  The axillary lymph node spread is considered more of a systemic process which the adjuvant chemotherapy treats.

[kmom]

Thanks so much!

You helped me understand the reason why my doctor did not pursue axilliary node radiation. He did not give me any specific reason.

[patterson123]

A related discussion, Radiation after chemo and masectomy was started.