Monday, March 28, 2011 Lynda asks

Q: Is chemo and radiation necessary after a radical mastectomy, when all cancer is removed

My aunt had a mastectomy 7 months ago. They removed the entire breast and lymph nodes under her right arm. Since the she has been taking chemo. She under went 4 months and the dr said she would be finished with no radiation. Near the end of her treatments they said she needed 12 more weeks, with no scan or tests they could tell us of. Now she has taken her last treatment today, and they say now she must undergo 6 weeks of radiation, still no tests.She is almost 80 years old and has not been very sick during her chemo. since our last visit when they said 6 more weeks she has been very sick. my question is are we wrong in thinking that this is alot of chemo for someone who doesnt have cancer if they got it all during her surgery

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Answers (2)

PJ Hamel, Health Guide

3/29/11 5:52am

Lynda, having a mastectomy doesn't mean the cancer is gone from your body; it means they removed the tumor and surrounding tissue. Some stray cancer cells could have left your aunt's breast and traveled elsewhere; probably when they removed her lymph nodes, they found some cancer in one or more of the nodes. And that would be why she had chemo, to kill any of those cells that had spread.

But chemo isn't administered without a lot of thought, and the plan for it doesn't change without a reason. Ditto radiation; it's not just added to the treatment plan on a whim. So, if you're her spokesperson, contact your aunt's oncologist, make an appointment, and ask the doctor these same questions you've asked us here. Only her doctor has the information about her diagnosis that would have informed her treatment thus far, and what's planned going forward. If you're not satisfied with the answers, ask for a referral for a second opinion.

Thanks for being there for your aunt. Good luck - PJH

Phyllis Johnson, Health Guide

3/29/11 6:13am

Lynda, one reason for doing chemo and/or radiation after surgery is if the pathology report shows that the cancer cells are aggressive. Then the doctors worry that some stray cells may have spread to other parts of her body. The other would be that cancer was in the lymph nodes. Checking the tissue from the surgery would not have been a separate test. Someone should have explained about it to your aunt.

But, I agree with PJ that changing the treatment plan after the first round of chemo and adding radiation at the end without more tests sounds unusual. I had two kinds of chemo and radiation after my surgery, but the doctor explained ahead of time that I would need it all and why. Maybe the doctor did explain this to your aunt, but she didn't understand what he was saying. Or maybe the doctor had this planned all along but decided not to tell your aunt at the beginning because he thought she would get discouraged at the thought of a long treatment plan. Whatever the reason, there have been some communication problems. Maybe you can go with her to her appointments and ask more questions.

Q: Is chemo and radiation necessary after a radical mastectomy, when all cancer is removed

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