Radiation after BMX for ILC?

Truffles1968

I see that some ILC Warriors are getting radiation in addition to chemo and/or hormonal therapy after BMX. Is this something I need to ask my MO about? My BS told me I didn't need rads at my BMX follow up but didn't tell me why and that was before my pathology changed (and changed again on third opinion). I see my MO on 2/3 to finally get my treatment plan after being Her2-, then Her2+ and now conflicting results from Hopkins pathology and Mayo pathology that will be decided by Oncotype DX results (even though it isn't usually used for Her2 my MO says).

Just worried that while all this Her2 stuff was happening I should have seen an RO.

Anonymous

Hi there, I did get rads, but they were before my MX. I went "whole hog" and had all tx I could, even though protocol would have let me go with just lumpectomy and rads, and not a subsequent BMX.

Did you have reconstruction with your BMX? I know that rads can mess with reconstruction, so that is a chance you'd take. For me, I just wanted to know I had tried everything 21c med had to offer to eradicate c. from my body. I'm not clear on HER2 issues, but I thought if you tested + you got Herpecin for a year to treat that.

Claire

Lojo

Hi Truffles,

I did have rads after my BMX, but it wasn't a given prior to surgery. The margins were close (I forget the distance, but really close, though officially clear), and both my surgeon and two radiation oncologists recommended rads to decrease the chance of local recurrence, and my medical oncologist deferred to them. I had a 4.5cm ILC tumor, clear nodes, low Oncotype score (ER/PR +, HER2- ) (it was borderline too big to do the Oncotype, but my doctors intervened and got my insurance to cover it).

So, rads, but no chemo. I'm on tamoxifen for 10 yrs or until menopause.

I don't know how the HER2 positive result would change the rads decision, but my impression from the docs discussions was that rads was not a given if nodes were clear. There is conflicting information on whether rads improves overall survival post-mx for people with no or only a few positive nodes. It does seem to help with lots of positive nodes.

If radiation is recommended, I would definitely get a second opinion so you will feel more confident in your decision. It wasn't fun, but wasn't too horrible. I did not have reconstruction, so I'm not sure how that would factor in to the decision.

ck55

I believe it may have to do with tumor size. If I remember correctly (it WAS over 9 years ago. ) with any tumor over 5 CM radiation was recommended

. Mine was 9 CM, so there was no question!

Cyndi

grandma3X

I think it has to do with size and/or node status. My pathology report came back with tumor size at the upper limit for T2 (5cm) so my BS is recommending that I consult with the RO.