Some Older Women W/ Early-Stage HR+ May Be Able to Skip Rads

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Some Older Women With Early-Stage Hormone-Receptor-Positive Breast Cancer May Be Able to Skip Radiation After Lumpectomy
December 22, 2020
Some women age 65 and older diagnosed with early-stage hormone-receptor-positive breast cancer with a low risk of the cancer coming back who have lumpectomy followed by hormonal therapy treatment may be able to skip radiation therapy after surgery. Read more...

Dunbar21

Hello. I'm new to this forum and would like comments, information and/or advice about possibly omitting RT before beginning hormonal therapy after my recent lumpectomy.I'm grappling with this decision after my medical oncologist and radiation oncologist gave me the option to have or not to have RT, based on my pathology report. I'm mostly concerned about the higher local recurrence rate if RT is omitted, and am not sure if long term I'm comfortable taking this risk. On the other hand, I'd like to avoid RT if the benefit is not that great.

Thank you for any input.

Dunbar21

Salamandra

Hi Dunbar21,

Some things to consider:

• How disruptive would RT be to your life now?
• What do you expect your healthcare/insurance situation to look like in years to come?
• If you do have local recurrence, you are more likely to need mastectomy, which is a higher intensity surgery how stressful will the surgery/treatment be on you, anticipating impacts of further aging?
• How old are you now and what is your life expectancy?

I was much younger so it wasn't really an option for me, but for what it's worth...

Hormonal treatment can suck. For some women it's a sugar pill but you don't know until you try it. I met a woman getting RT with me who was in her mid 80s and she refused hormonal treatment and/but her docs insisted on radiation. She had some fatigue but basically handled it fine.

Some people at 65 anticipate living another 10 years if they're lucky. Some anticipate living 20+.

My impression is that surgery just becomes riskier and more stressful the older a person gets.

I think that radiation can make it safer to quit hormonal therapy if you end up not being able to find one that works for you, and can preempt future surgery. I think that if I were older than 65 but expecting/hoping to live past 80, unless there are contraindicating factors for me personally, I would strongly consider RT.