Radiation - yes or no?

Looneymom

"Cat123 For any of you posting....did you have a mx and still opted for rads?  I had a tissue expander after my mx and if I choose to have rads...it totally screws up my reconstruction for a few percentages points of cancer coming back"   Reply to Cat123 

Cat  I had my rads with a fully expanded TE in place.  My choice I waited 2 years for my exchange.  My PS wanted to wait 6 months but a new job and life interfered.  I just had my exchange done this Dec. 10th.  I think we are all glad for the extra healing time.  I had lots of scar tissue on that TE foob for sure.  I called it my 18 yr old foob, really what is great with all the scar tissue is -  it is a built it bra! I had more discomort on my un rad TE foob. Told him to make it like the rad side because it was firm with all that saline water weight.   2 years ago there were only 5-10 of us with rads and TE and plans for implants on the fourm at the time, it was not common practice. .  I think I knew 2-3 members that kept their implants for over a year or more . But now there are a lot with the same situaiton since I posted  2 years ago.   Used to be a 40-60% reject and most PS don't even want to do it because of fail rate.  I picked my plans before I knew I had to do rads so he worked with me.   I think he has written some med. papers on my treatments & complications so it may help others in the future either way.  I do make the remark that I am a science experiment because I have had a few practice things done with and without approval.  I get mad for a while then move along. Life is that way.

MarieKelly

MHP70 wrote: ...I'm not talking about local recurrence.  I am talking about a recurrence of the original cancer, which can happen anywhere in the body And, according to the three oncologists I got opinions from, this is a fatal situation... 

A recurrence of an original breast cancer after lumpectomy can be 1) LOCAL (within the breast) or REGIONAL (in the nodes) or 3) LOCO-REGIONAL (within the breast & lymph nodes)  or 4) DISTANT (areas outside of breast and nodes).

Yes, distantly metastatic disease, whether it's present when originally diagnosed or doesn't become evident until after a recurrence, is considered non-curable and eventually fatal. I'm sure that's what your oncologists were referring to when you got the answer "because it's terminal". However, as mentioned in my earlier post to you, having a recurrence somewhere other than distantly, will still be treated with intent to cure and long term disease free survival (DFS) is a reality for many.  True to form as with anything about any kind of cancer, there are a lot of  different prognostic variables in dealing with a recurrence that indicate who has the better chance chance of  achieving long term DFS after a recurrence. 

Distantly metastatic disease is treated with the intent to control, but not cure, the cancer. All other types of recurrence are treated with the intent to cure until when and IF it becomes distantly metastatic - at which point the goal of treatment switches to intent to control and eventually palliation.

Here are just a few of the studies that will show you that recurrences, and sometimes even 2nd recurrences, are not necessarily a death sentence. In certain situations, some people actually can just "treat it again" conservatively without too much fear of compromising survival.

Int J Radiat Oncol Biol Phys. 2005 Nov 1;63(3):845-51.

Ipsilateral breast tumor recurrence after breast conservation therapy: outcomes of salvage mastectomy vs. salvage breast-conserving surgery and prognostic factors for salvage breast preservation.

Alpert TE, Kuerer HM, Arthur DW, Lannin DR, Haffty BG.

http://www.ncbi.nlm.nih.gov/pubmed/16199315

When can a second conservative approach be considered for ipsilateral breast tumour recurrence?

http://annonc.oxfordjournals.org/content/18/3/468.long

Oncology. 2003;64(1):1-6.

Repeat lumpectomy for patients with ipsilateral breast tumor recurrence after breast-conserving surgery. Preliminary results.

http://www.ncbi.nlm.nih.gov/pubmed/12457024

LtotheK

Wonderfully informative, thank you for those links.  I plan to read over the holiday, and wish my oncologist would point me to these studies.  But that's what this board is for.

Regarding the original post,I guess the bottom line is, they can't say which type of recurrence will happen. Until they do, it's why they recommend the most aggressive treatment in the hopes of avoiding the distant recurrence.  It's sad, as it is still very primitive methodology.

I also still fundamentally don't understand why the distant recurrences aren't treatable, just as one or many tumors within a region are.