Radiation Effectiveness - Stage, Grade, Lymph Node Status?

Italychick

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Hello. I'm hoping I can get some assistance with real data. I am at a position where I have to decide to pursue radiation or a mastectomy in a few months. I am looking for research, stats, etc. related to the effectiveness of radiation vs. mastectomy, but I have been unable to find anything that breaks down effectiveness in terms of stage, grade or lymph node status.

Does anybody have any insight, or links to articles I can read? Much appreciated!

Italychick

Sorry, I should have also added that I am looking for studies related to breakdown based on hormone status as well, if there are any.

Italychick

anyone?

Meadow

Hi Theresa, I saw your post the other day, but I didnt have an answer for you! I had both mastectomy and rads, (after chemo) which is the protocol for my type of cancer. Sorry Im no help! Have you checked the radiation forum here on BCO for info?

Hopeful82014

Theresa, if you do find any stats please PM me, as I've been looking for same. Thanks - and good luck.

goodcanary

My breast surgeon as well as my radiation oncologist were able to lay out plain numbers (percentages of recurrence, both invasive and noninvasive for the various permutations of treatment) for me as I was trying to make my choices. The breast surgeon even had her nurse practitioner looking up studies for me to find the scenarios I was trying to consider. The RO is at an academic medical center, which I think makes a difference, that she was on top of the latest studies and data. I also liked looking at the Memorial Sloan Kettering nomogram, but it is specific to DCIS; perhaps a similar tool exists for your diagnosis? I turned myself into an "expert" on DCIS but don't have knowledge beyond that. Best of luck to you!

P.S. just noticed there is another current thread that called "rads percentages" that might help.

JJOntario

I had the same choice as you and I did rads. It seemed less extreme and I was told it gave the same outcome. Knowing I had a choice made me think about losing my breast and I found myself not wanting to. I took my chances with rads. I'm two wks post treatment and ithas not been an easy time...and I'm still learning about the effects of radiation. None of these decisions are easy.

Italychick

I looked at the rads percentages forum, and it is still confusing. The numbers thrown out by all my doctors seem to add up to over 100%, which I know isn't possible. I just don't want to go through chemo and rads only to find out I should have done the mastectomy. It is scary because I have seen fast recurrences and want to make the right decision for survival. I will keep researching, and if anybody finds anything, I would greatly appreciate input. It seems like everything I find lumps all the stages together. So confusing

I_Spy

Italychick I was in your shoes a few weeks ago, and I chose PBMX. I'm a research and stats person too, and even after looking at every piece of data I could find and discussing it with bs etc., I think it comes down to what you feel is the right thing for you to do. It is a wrenching decision no matter how you cut it. I finally had to say to myself "ok the problem is: this is not a choice between Disneyland and Six Flags," and I felt better. There are drawbacks to both, and you wouldn't choose either if you could help it. So look at all the data you can find, and then realize that you probably aren't going to go "Yay!! This is the decision I'm so happy!" It is going to be the best decision you can make in the circumstances. I don't think I answered your question but I wanted to chime in and say I know how hard this decision is. I'm in San Diego too -- what hospital are you at?

Italychick

Scripps Encinitas, and Laurie Frakes is my MO. I see that all the doctors can provide Input, but everybody conflicts and seem biased towards their particular practice. The assumption seems to be with great margins (smallest was .5 mm) and no nodes, do the radiation. But I am leaning to mastectomy. I am 4 years post menopausal, and still have very dense breasts, which is concerning. I don't want to be in the roller coaster of ok, we got that lump out, now here is another one to deal with. But I also know mastectomies are not without side effects.

Even my HER2 was borderline, and the choice was left up to me regarding Herceptin so I had to research the crap out of that. Great! $500,000 worth of treatment, and the decision is left up to me. I did the Herceptin because I am afraid not to if it has any chance of working

I_Spy

We sound very similar with the educated patient approach. I'm at UCSD Moores Cancer Center. Here's an idea: get a second opinion. That's what they're for, after all. Most insurance pays for it, too. I highly recommend my bs Sarah Blair at Moores Cancer Center. She sat me down and said "Are you sureeeeee you want a PBMX?" even though she brought it up first haha. But I'm the same way: dense breasts, mother and maternal aunt died of bc, I've already had a lumpectomy for DCIS and now I have a papilloma that grew in the last six months so prolly has some cancer in it. This was the hardest decision I've ever made in my life. Dr. Blair wanted me to do at least tamoxifen but radiation too, and I just didn't want to because I don't want to risk that we won't find a recurrence because of my dense breasts. But again, I could make an argument for both courses of action! That's why it is a hard decision, and we just don't have a crystal ball to tell us what the right decision is.