SHould I have bilateral mastectomy to replace the radiotherapy?

wendy_69

Hi, ladies, I'm new to this forum. I was diagnosed with TNBC on 10/18/2011 and since then I have been nurvous. I had lumpectomy on 10/27/2011 with clear margin, but surgeon only cut 3mm margin toward the chest wall direction since the tumor was close to the chest wall. Lymph nodes were negative. I have finished 4 doses of AC and 3 doses of Taxol. 1 more to go. I am supposed to have radiotherapy afterwards. After knowing the triple negative is very agressive and finding some ladies had local recurrence, I am debating to have bilateral mastectomy instead of radiotherapy. But my surgeon pointed me to an article indicating that patients with triple negative cancers have a lower risk of local (breast/chest wall) or regional (lymph node) recurrence when they recieve radiation. http://journals.lww.com/amjclinicaloncology/Abstract/2011/06000/Locoregional_Recurrence_in_Patients_With.4.aspx

He recommended me to have radiation. If I want to have mastectomies, he asked me to wait about 6 months after the radiation. But radiation oncologist said that would be redundant and I should do either one. 

 I am having difficult time to make the decision. My highest priority is to kick this terrible cancer far away, I don't mind lossing my breasts (my hubby has the same opinion). Are there any ladies having the sequence of lumpectomy-chemo-radiation-mastectomy? Is lumpectomy with radiation a safe choice for TNBC? Your advice/suggestion would be greatly appreciated!

naturalhorse

Hi there,

I was originally Stage IIb TN.  My course of treatment was chemo-bilat mx-chemo-radiation.  In my case I had the mastectomy and the radiation to kill anything local/regional.  The difference is that I did not have a lumpectomy first.

 I hope this is in someway helpful,

kc 

guitarGrl

I went the lumpectomy/chemo/radiation route and have been good for four years now. So is it safe - yes, for me it was.



The trouble is that whatever choice you make, you'll probably always second guess yourself. I was sure when I was first diagnosed that I didn't want a mastectomy. Then I did some reading here and saw that everyone was advocating it. But my doctors didn't. So every once in a while I wonder if I made the right choice. I like your doctor's advice about waiting six months. It would give you a chance to really think about what you want. Radiation is just one month, and while it's a pain while you are going through it (mostly because you have to go five days a week), I don't see any lasting problems because of it.

cookiegal

I probably shouldn't jump in here, I am not a TN but...there was a huge study that showed lump+rads was slightly superior to mast alone in terms of overall survival. I think it may have involved something like 10,000 people.

I also recall a study that tripple negs are one of the few groups where there is an overall survival benefit to a double mast, but it was slight. Maybe 5 percent.

So that is not much of an answer, it is kind of a toss-up, but I think your doctors advice is sound. Get the benefit of the radiation now. You can always do an elective bilat down the line. 

Again sorry to jump into a forum where I have no business, but the past two years have made me a BC geek.

wendy_69

Thank you all for your replies. I will go ahead and have radiation first and have double mastectomies later.