Opting out of Radiation

Alcie1

I finally decided not to have radiation after my lumpectomy. This is not for everyone! I'm past the 3/4 century mark, had good scores on all the testing, not likely to metastasize out of the breast, and I consulted with all my providers, not all of whom agreed, but my decision shouldn't make any difference in my mortality.

This was my second IDC, after 12 years. The first time around I didn't tolerate treatment, rads and hormone, well. But my main reason for not getting radiation is the awful ugly breast I can't live with the way it is. I'm going to get plastic surgery. Plastic surgery wouldn't be successful if I would get radiation. My radiologist confirmed my belief that the already hard tissue would harden more and look worse after treatment. I think of it as a piece of chicken that has been cooked too long in the microwave. That's what the other area of the breast that had radiation previously has been like for 12 years. The nipple is retracted so that it looks like a mouth, and the rest of the tissue was drawn high up into a lumpy ball. The volume after surgery is still plenty to fill up my D cup.

Before surgery I was ok with a mastectomy, but was insisting on a double, as I'm fairly large and didn't want a heavy weight hanging on one side. I was delighted that it was possible to do a second lumpectomy, because that would be less surgery. But the result has been as bad as going flat, to me.

I understand it's 20% or so likely that there will be a recurrence in the same breast. If that happens a mastectomy would be necessary. But the statistics for survival are the same. I will have to keep up surveillance with mammograms. I will also try hormone treatment, but expect I won't tolerate it, like the last time.

Again, this is not a recommendation for others. I had good Oncotype and other test scores and am old. Each of us has to make decisions based on our own circumstance.

Beesie

Sounds like a well thought out decision.

Did you have good surgical margins with the lumpectomy? That could drop recurrence risk to less than 20%. I think the grade of the cancer factors into the local recurrence risk estimate too.

Rads for older women is controversial - some studies say that it is given more than necessary, while other studies suggest that it should be given if the patient is healthy enough to tolerate it. So it doesn't seem to be clear either way.

Good luck with the plastic surgery!

Alcie1

1 cm margins all around. My surgeon gave me recurrence number even higher. I did a lot of reading of scientific reviews of studies. I thank my radiologist for helping me organize my thoughts while making sure not to push me in any direction.