Radiation after Mastectomy? Searching for study/statistics

hipposinnyc

Hi -

I am new here and searched through the community posting but was unable to find a similar question....

It was recommended to me to have radiation therapy, although I had a mastectomy and although I am only a Stage1 / 1 Lymphnode involved. The reasoning of the oncologist is mostly my age (47) and the fact that I had 4 tumors (1.9cm / 1.5cm/ 1.0cm / 0.7cm). He says that we can't ignore the fact that combined they are over 5cm. My oncotype is 25.

My doc says there is a Danish (or Dutch) study in which it is shown that women under 50 profit from getting radiation therapy and that the recurrence rate would decrease from 25 to 15%. Is anyone familiar with this study?

Does anyone have a similar case history and had the same treatment recommendation?

Grateful for any answers which make the decision to get or not to get radiation therapy somewhat easier. THANKS

ElaineTherese

No, I haven't heard of that study, but someone else may have. I would have gotten radiation even if I had a mastectomy, but that's because my tumor was large (5 cm+), and I was HER2+ and Grade 3 -- signs that my cancer was aggressive. You are Grade 3 as well, suggesting that your cancer is on the aggressive side. Your signature also doesn't say that you're getting chemo. Frankly, radiation was easy for me, compared to chemo. Still, chemo does provide systemic treatment, but you can also get that from hormonal therapy (Tamoxifen or an AI).

Hmm... Radiation is a localized treatment, designed to prevent recurrence in the breast area. Local recurrence is scary, but not as scary as mets to other parts of your body. If you're committed to doing hormonal therapy, you could skip radiation, I guess. It's up to you. You can always get a second opinion if you're not sure about your doctor's recommendation. Best wishes!

TB90

I am also unaware of that study unless you had a positive margin. Are you aware of your margins? Please feel free to ask for the particulars of the study they are referring to. You are entitled to all the info they have in order to make the best decision for yourself. You are the one to decide your treatment plan as often these unusual situations have no definitive answers. Makes it more difficult, but as you gather more info, and assess your personal needs and tolerance for different risk factors, the answer becomes easier. Good luck and all the best!

Moderators

Hi Hipposinnyc-

We want to welcome you to BCO, and we hope you find this to be a place of support.

We have some information on our main site about why radiation is recommended even after a mastectomy: http://www.breastcancer.org/treatment/radiation/wh.... There's also a link on that same page with links to current research on rads, some of which you might find helpful. Also, check out our forum on radiation, lots of great info and knowledgeable members there: https://community.breastcancer.org/forum/70

Hope this helps!

The Mods

hipposinnyc

Thank you kindly for your prompt post. Very much appreciated.

I had two opinions. Both recommended the radiation therapy as well as Tamoxifen. No chemo though (-:

hipposinnyc

Thank you as well for your comments. Much appreciated. My margins were all clear.

muska

Hi hiposinnyc, Komen's website has some study results you might be interested in, including an older Danish study: Komen on radiotherapy after mastectomy

A more recent meta analysis study showed that " radiotherapy reduced both recurrence and breast cancer mortality in the women with one to three positive lymph nodes in these trials even when systemic therapy was given. For today's women, who in many countries are at lower risk of recurrence, absolute gains might be smaller but proportional gains might be larger because of more effective radiotherapy": Effect of radiotherapy after mastectomy

wendymk2016

Hi hiposinnyc,

Do you mind to share your margin status?

I have a close margin after mastectomy. But my SO and RO is pretty confident that I do not need Radiation therapy. I am going to seek for a second opinion from a RO from different hospital. If he also confirms the story, I will not worry about not having radiation. Besides, I will start taking Tamoxifen which will also help to minimize the risk of local re-occurring.

hipposinnyc

Hi wendymk2016 -

my margins were clear / not sure if that is the accurate medical term, but they said there is nothing there. How old are you? My RO said that with an older women he would NOT recommend the radiation, he is only going for it because it seems to be a better outcome for patients under 50.

Hope this helps. I kind of wish they would not have recommended it... Really dreading the radiation. But I will start only in December, as we are going on vacation before I start

wendymk2016

hiposinnyc,

I am just turning to 40. My surgery said my margin is close (idc 1mm, dcis<1mm)because I am very tiny. She already took out everything she could. Because there is no fat in my breast so she already remove the tissue as clean as possible.

So, from her perspective, there is nothing I can benefit from radiation treatment..

Wendy

grainne

hi, hipposinnyc. I have no advice as to whether or not you should have rads as my diagnosis is very different. I just wanted to let you know that my own experience was absolutely fine. I had 15 sessions plus 3 boosters for a close margin. I had no skin irritation and hardly any tiredness, even though i worked throughout and drove 100 miles a day to the unit. it was a time consuming nuisance but no more than that. Good luck

hipposinnyc

It sounds like a second opinion will give you a piece of mind on this. It certainly helped me to come to a decision, although I still am looking for the study itself. Good luck with everything and feel better!

Kat104

I found this review yesterday, if anyone is interested:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC37864...

Hipposinnyc, best wishes for starting your radiation this month! I hope it goes much more smoothly than your expectations. Sounds like you have peace of mind on your decision, and that goes a long way.

Jennie93

I had to have rads even after MX. The RO said it was because I had positive nodes. Margins were good. They radiated the chest wall and the remaining lymph nodes. Boosts right on the scar. I tolerated it pretty well.

My RO was excellent, very patient, never rushed me, answered all my questions. Showed me the scans and how they were careful to avoid the heart & lung and all that stuff. Told me exactly what to expect every step of the way. It went pretty well.

hipposinnyc

Thank you so much for that link, that was helpful. I had my first Radiation just an hour ago. So far, so OK....

Wishing you all the best with your treatment!