Questions for RO

Ilovethemoon

Hello!

I had BMX, 1 SLN removed (-). Was expecting to have chemo d/t Oncotype score of 52, but was NOT originally expecting to have radiation tx since I was having a mastectomy. Surgical margins came back clear but "extremely close" at 0.5 mm on the superior margin (I really have a hard time of visualizing exactly what that means in relation to where the tumor was/what was removed from my body). MO wants me to talk to RO. Will have chemo AC+Taxotere starting soon (4 rounds of each). I have TE in place with current plan to exchange for silicone implants before chemo starts. I did NOT want to start reconstruction if I was going to have to have radiation, because of potential complications with rad/implants, but here I am.

I'm 44 years old. I have a 12 year old daughter. Part of me says - throw everything at this. Another part has heard radiation tx horror stories and wonder if the benefits actually outweigh the risks. I meet with RO next week. What questions should I ask to help me make this decision?

Thank you!

HeartShapedBox

Hello, Ilovethemoon! All of this is a game of odds and statistics, and making the best call with that info. On one hand you had a small, hormone+ her2- tumor and no positive nodes, which gives you good odds. On the other hand, you're young with a long life to hopefully live disease-free, with a higher oncotype and closer margins than you'd like. In the end it's up to you to make those calls and take those odds. I will say, of all the treatment I've had (chemo, mastectomy, radiation), radiation was by far the easiest on me, so that piece of extra security has been worth it for me. It's a long time commitment of getting to radiation every day/ potentially taking time off work, but it's a BRIEF amount of time each day for actual treatment, if you're not going to a large hospital with a long wait, and if the time commitment isn't a major inconvenience, you really don't have anything to lose (& will likely have a low dose/fewer days than those of us with positive nodes!). Even if you respond poorly to radiation and end up a bit burnt, it doesn't last and is over when it's over! But in the end, you really have to weigh all the given factors in your own situation. For me, chemo was hard on me, surgery was hard on me, but radiation has been the easiest of all my treatments so far, and was well worth the added nuisance and discomfort.

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Ilovethemoon

Thank you for sharing/responding HeartShapedBox! I hope you are doing well in your recovery! I am definitely a worrier. I do feel that having the radiation wlll likely give me the peace of mind that I did everything I could to prevent recurrence. I think if I wasn't going to have the implant in place at the time of rad, I would be less worried about complications from it. I have waxed/waned about doing radiation tx but currently leaning towards doing it - for that peace of mind. I don't feel like I was prepared enough for the PS/asked enough questions before, and so now I guess I'm just looking for guidance as to what I should ask the RO when I meet him next week. Are there specific questions I should ask him/certain things I should request/prefer? I just want to make sure I am advocating for myself.