Radiation necessary? Which treatment to choose?

grandmaadams

My oncologist/surgeon and radiation oncologist want to schedule radiation as soon as I have a follow-up MRI. I had a lumpectomy and sentinel node excision, I'm 62, hormone receptors positive, Her2 negative and Oncotype DX score 10 (7% chance of recurrence with hormone blocker). Fortunately I won't have to have chemo.

My radiation oncologist is suggesting full breast radiation for 20 treatment (I think 16 treatments and 4 boosts), other options are the full breast without the boost, 3D conformal external beam radiation (still researching). My surgeon/oncologist believes I'm a good candidate for partial breast radiation ... 2 treatment per day for 5 days which targets the radiation on the tumor site (high dosage each visit but less total than full breast).

How do you decide which is the best option? Has anyone with a low Oncotype score skipped radiation with the approval of their oncologists? I hate to admit the fear of making the wrong choice and long-term effects are creating anxiety. Anyone have any suggestions?

Georgia1

Hi Grandmaadams. Those are a lot of choices! With a low Oncotype score the short course with boosts (often called the Canadian course) presents the fewest side effects so that's what I did. (Age 59, Oncotype DX of 18, tumor on right side). We discussed partial breast radiation, which can have a poorer cosmetic outcome and discarded it because my boobs are small so "partial" would really be most of my breast anyway. But if your radiation would be on the left side, nearer your heart, that may be something to consider.

Salamandra

What did you end up doing?

grandmaadams

Hi Salamandra. After a lot of research by me and my husband, I had the time due to waiting for the MRI before radiation started, I chose the short course with boosts. I had 15 full breast radiation treatments and 6 boosts to the tumor site. I had some side effects, a little reddening and the crease underneath my breast became pretty irritated. About a week after treatment the skin underneath my breast pealed. Still a little pink but improving every day. The cancer was in my right breast so I didn't have to worry about radiation near my heart. The daily dose was a little higher per day than the longer course but since there weren't as many days, I received less radiation overall. Good luck with your choices.

Salamandra

Thank you for responding!

I just started last week. My breast and chest already got redder, so I'm pretty nervous.

grandmaadams

Hi Salamandra. Hang in there lady, it will be over before you know it. As my oncologist told me … keep enough aloe vera (or whatever lotion you're using) on your breast till you are sloshing out of your bra and drink enough water to stay hydrated. If your skin begins to bother you, don't be afraid to talk to your nurse/rad oncologist and ask for something to help. The crease under my right DDD breast is where I had the most irritation but it wasn't unmanageable. Applying Neosporin with pain relief to the crease helped. My last treatment was on October 31st. What I wasn't expecting was the emotions after the treatments were over. For five months it was testing, biopsies, diagnosis, doctor appointments, surgery, healing, more appointments, radiation … and then suddenly it's over. I felt like screaming WAIT, there must be something else I can do or need to do to make sure this doesn't happen again. What had been the center of my world was "over"? I do have an appointment at the end of the month as a follow-up with my oncologist which will be two months after my last rad treatment. I am told there will be regular appointments now every 3 or 6 months but I think it's mainly for meds check. I am taking anastrozole and so far no side effects. I've been very fortunate in this journey. I'm sharing this because when I expressed the feelings I was told it wasn't unusual, a lot of women felt the same way. So, heads up, don't be surprised if when the rad treatments are over you feel a little saddened that you aren't still fighting. Take care and I wish you the best on your journey.