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When I had my lumpectomy there were 8 of 11 positive lymph nodes. They were NOT matted, but there were cancer cells between them. The doctor removed all of the tissue that felt hardened--all of the "gross disease".

I have lobular cancer. They did extentsive A/C and carbo-taxol chemo.

Then a double mastectomy (but removed NO more lymph nodes were removed--because they looked all right on ultra sound.)  Also, my doctor did an mri with and without contrast of the axilla, and it did NOT light up.

Now I am having radiation.  And taking AI's.

What I want to know is--in about 3 months I will have a CT Scan. What if it shows that some of the lymph nodes are still positive? Is this likely to happen? If it does, what do they do? Remove them surgically?

Thank you.

Category: Oncologist

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Category: Hematologist
Dr. Prasad Eswaran is online now

Expert:  Dr. Prasad Eswaran replied 4 Days.

Thank you for your query at
Specific answer to your query will be based on the number of nodes which look radiologically different from normal nodes. Additionally treatment would change based on any other site of metastasis. The whole treatment process is considered based on the volume of the disease, site of metastasis, number of metastasis and prior treatment.
Hope this answers your concern.
Kind regards,

Patient replied :

Thank you for your answer. I guess my main question was, is it likely for lymph nodes to be positive after radiation? The ASCO website says that radiation is as good as surgery. What do you think?

Expert:  Dr. Prasad Eswaran replied 3 Days.

Yes indeed. But not always, Radiation does kill cancer cells and cure, but if a cancer cell undergoes more adaptation, it can survive too. This is practically unpredictable.
Hope this helps, Kind Regards

Patient replied :

So, wait. You are saying that yes, it is LIKELY for lymph nodes to still have cancer after radiation?

Also, could you please tell me what this means. It is from the report of the MRI of my axilla, done in July:
"surgical changes are noted in the right breast and axilla, with scarrihg. Dense tissue is noted in the axilla. This does not show enhancemanet with gadolinium. No discrete enlarged nodes identified."
Does this mean that whatever cancer is in the axilla is probably minor, and the radiation will kill it?

Expert:  Dr. Prasad Eswaran replied 2 Days.

It depends on the radiosensitivity of the cancer cell. Each cell varies in its own with respect to survival instincts after radiation . Breast cancer comes. As moderately sensitive category.
Kind regards.

Dr. Prasad Eswaran
Category: Hematologist
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
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