How necessary is rads after chemo and mx?

deenah

How necessary is rads after chemo and mx?

deenah

I was diagnosed with Stage IIIa breast cancer in March.  Originally I was supposed to have surgery, then chemo and radiation.  The original PET/CT showed approx 8-9 cancerous lymph nodes under my arm, 2 mammory nodes with traces of cancer and 1 node in my neck with traces of cancer.  After finding out about the mammory and neck nodes, my treatment switched and I did chemo first.  I just finished chemo last week and have my double mastectomy scheduled for Sept 9th.  I just got the results from my latest PET/CT scan today and the cancer is completely gone from all lymph nodes.  I still have cancer (although instead of 1 mass, it is broken up) in my right breast.  Now that the lymph nodes show no evidence of disease (obviously we won't know that for sure until surgery since the tumors have to be of a certain size to show up on a PET), do you think there is a chance I could avoid radiation?  I'm just curious to see if anyone else has had this scenario happen to them?

 I have seen my local radiation onc, and have an appt for a second opinion with the UCSF radiation oncology department on Sept 3rd.  

Decisions, decisions!!

dlb823

deenah ~ bc cells are known to want to return to their original site.  RT basically sterilizes the area where you've had a lesion or tumor or positive node, to prevent a regrowth from occuring. Even though your nodes may appear NED after chemo, I think I'd personally wonder if a few stray cells might have survived, unless a trusted medical team could assure me that they hadn't.

Hopefully, UCSF will come down definitively on one side or the other for you.  From what I've experienced, the teaching hospitals like UCSF are known to be more aggressive, so if they say it's not necessary, I'd be okay with that.  On the other hand, if they recommend it, I'd listen to them.  That's what I did after a mast & chemo and input from multiple rad oncs -- followed UCLA's strong recommendation for rads, because I trusted them.  And even though I'd really worried about doing them, they turned out to be a piece of cake -- nothing compared to chemo.    Deanna

dlb823

oops, sorry... double post...

deenah

Thanks for the input Deanna!  I've talked to my oncologist as well as researched online, and I know at this point I have to have rads.  Which is totally fine.  I know it will be a cakewalk compared to chemo. 

Now I just have to decide about doing immediate reconstruction vs. delayed.  I will hopefully have enough info the make an informed decision after meeting with 2 plastic surgeons, as well as UCSF radiation department next week.