Quick background:  My wife who is 50 discovered swollen lymph nodes in her
rt. axilla just before Christmas.  All diagnostic tests; wholebody CTs, MR,
Ultrasound, Diagnostic Mammo... were negative -- nothing at all suggested.
She had a surgical biopsy of a lymph node which came back as a poorly
differentiated adenocarcinoma.  PET scan the following day showed distant
disease in her supraclavicular region, multiple sites in her rt axilla and
mediastium.

She had 16 weeks of chemo; 4 infusions of adriamyocin/cytoxen and 4
infusions of taxol -- infusion done every other week.  The PET scan post
chemo showed no evidence any distant disease.  Last week she had a axillary
dissection and the path report  came back today.  Evidence of cancer cells
in 3 of the 11 lymph nodes removed, tumor extension in the peri-nodal soft
tissue.  My wife had the expectation that the primary tumor would be found
in the tissue removed during the dissection.

She is scheduled to undergo 6 weeks of radiation therapy in about 2-3 weeks.
Her physicians are fairly certain the culprit lesion is breast cancer due
to her presentation and cell expression (estrogen+).

The question were struggling with is a mastectomy or not?  In reading
several articles on occult breast cancer it seem outcomes are similar for
chemo/rad therapy compared to chemo/rad and surgery.

Since cancer cells were found in the lymph nodes, I'm taking that to mean
the primary tumor is still shedding cells and these cells in the lymph nodes
are not residual.

Anyone else undergoing treatment for occult breast cancer, that would be
willing to share their treatment plan?  We've made an appointment for a
second opinion at Hopkins.

Thanks!!!
dwk