Boost or no Boost?

Padug

I have had a mastectomy with clear margins and a skin expander. My doctor wants do the boost. I am concerned about the boost causing damage that will affect my reconstruction. The Dr. says the boost is because I had LVI ( Lymphovascular Invasion) My tumor was near the nipple, which I no longer have. I am planning on reconstruction with a DIEP flap and replacing the nipple bump with skin from the abdomen. During that procedure, as I understand it, an island of skin from the center of the breast will be removed and replaced with skin from the abdomen. So my questions is, do I really need the boost? If most of that skin is going to be replaced anyway, why go through the extra radiation exposure and additional skin damage? Doesn't removing that skin remove the risk? I had a consult with 2 different doctors before choosing where I wanted to be treated. The other doctor I saw it was fine if I wanted to skip the boost. This doctor is adamant about doing it. Thoughts?

JRNJ

Hi Padug. Sorry no one replied. I’m wondering the same thing. Dr wants to boost the scar but I’m getting diep. I’m actually thinking boost should be on the armpit. What did you do?

Padug

Hi JRNJ. My Radiation Oncologist said the PS would not replace all of the skin that would receive the boost. I still decided against it. I did read a study that surveyed doctors and said more older Drs. than younger ones recommended the boost. Mine seems to favor more traditional treatments. The boost seems to be slightly controversial and I personally did not want to risk the extra damage. The boost is always on the scar, as they say it is a more likely area for a reaccurance. I don’t think you would want to boost the armpit due to Lymphoedema. Good luck with what you decide

JRNJ

Thanks for the info Padug. I’ll look into it more. So frustrating that every part of this process has different opinions, different choices..... my dr is actually on the younger side. I went for second opinion on chemo at Sloan. I thought radiation was more straightforward. I should have known. I do lean towards more aggressive though. He said it is not stronger just more targeted.