Radiation or not?

susieQ610

Has anyone else been recommended to do Rads after mastectomy when the only risk factor appears to be tumour size, 4.9cm.?? My margins were really good over 10mm and only one lymph node positive, no lymphovascular involvement etc. I saw a radiation oncologist recently who insisted that I had a 25% chance of local recurrence. She based this estimate on "lots of studies" After looking at lots of research papers "lots of studies" appear to include all women with all cancers grades and unclear margins etc.positive nodes etc.  I have asked for a second opinion but it appears that there is a cut off in size of tumour where they recommend Rads irregardless of other factors. Anyone else had a similar expereince - would be very greatful for advice?

cheers, Sus

Beesie

Susie, according to the NCCN treatment guidelines (which are what most docs in the U.S. use as their guide), you are right on the edge of two separate conditions for which they recommend radiation.  First is that you have 1 positive node.  With 1 - 3 positive nodes, they say that radiation should be "strongly considered".  Second is that your tumor size is 4.9cm.  Radiation is recommended for tumors that are 5cm or greater in size (regardless of nodal status), so you are just a tiny bit below the line on this one.  But with the combination of both factors, I can see why you are being told that radiation is necessary.

Page 11 of the guidelines covers the recommendations for your type of diagnosis:  http://www.nccn.org/professionals/physician_gls/PDF/breast.pdf  You may need to register to be able to view the guidelines. 

dlb823

Sus, I agree with Beesie.  4.9 is a fairly sizeable tumor, and the fact that you had a positive node -- I think I'd be as aggressive as possible now.

Your dx line says 1/1 positive nodes.  Did your breast surgeon ever suggest going back to check your other nodes?  Assuming he/she did not, that might be another reason to have RT -- to sterilize that axillary node area, just to be on the safe side.      Deanna

susieQ610

Thanks very much ladies for helpful info, especially the link that I looked at.

I did have an axillary clearance after they found pos sentinal node. All other nodes were clear. I get the feeling from the first rad consult that I am just over the line because of the size of the tumour. I really would like to avoid Rads for fear of damge to heart and lung tissue. Hopefully getting a second opinion will help me to decide. have looked at heaps of info online, my oncologist told me I,m reading too much!

regards, Sus