DCIS, Radiation therapy on left side versus mastectomy

Ker1hay

hello, this is my second time with DCIS, almost exactly same as about 7 years ago , but this time is on the left side... last time I had lumpectomy and radiation, which all went well. I’m concerned, does anyone know if it’s more harmful to your heart , getting radiation on the left side? Are there different types of radiation? I’m going to meet with the surgeon to discuss.. maybe mastectomy on left side only, versus lumpectomy and radiation, I don’t know of other options...I’ve already had MRI and ultrasounds,and found out today no more biopsies needed.

tntnsd

Hi Ker

I had DCIS on my left breast too, and when I talked to my radiation oncologist, he did mention there is a risk of radiation on the heart, although there are many techniques these days to protect it from radiation treatment (he did show me the link below as I ask for more info to read on later). Anyhow, I ended up with mastectomy for my left breast given the amount of DCIS showed on MRI, my breast size, and I don’t want any risk to my hear. He supported me 100% and stated on the records that I wasn't a good candidate for lumpectomy/radiation.

You should need to talk to your oncologist to learn about the risk with your case, and see if you are comfortable with that.

Best wishes.

https://www.mdanderson.org/cancerwise/How-we-protect-breast-cancer-patients-hearts-during-radiation-therapy.h00-159223356.html

alissat

Hi Ker1hay,

Left side for me as well. I had a BMX & still ended up doing radiation due to node involvement. My breast surgeon & RO felt that the benefits of radiation treatment outweighed the risks. Yes there are risks however they have techniques & processes to minimize said risks. If there is a chance you may need radiation you should consult with an RO. Once you have all the information, you can make the best decision for you. Best of luck!

Salamandra

I think that in this situation it is even more important to make sure you are going to a state of the art cancer center with top notch providers. But yes, many women get left side radiation and the risk is deemed either minimal or worth the benefit. Keep in mind also that since many of the heart risks of radiation are long term, that means that you can't necessarily rely on the risk-calculation research that is based on 15+ year old technology. On the flip side, of course, it also means you can't necessarily rely on the claims of risk-reduction/elimination of the most modern technology - since the evidence won't really be there until 15+ years into the future!

So I would say the best thing you can do is to consult with doctors you trust, talk it through with people you trust (maybe including here), and follow your heart and mind.

Ker1hay

thank you I’m waiting for surgeon appointment soon

Ker1hay

I appreciate your info! It’s a tough choice because it’s possible unknown side effects way down the road !

VegGal

I was told that heart, lung and bone (rib cage) damage is a given with radiation. It may not be severe, but it was unappealing to me as I already have a disease that can impact my breathing and my mom passed from heart failure so I wanted to keep those organs in the best shape possible.

Good luck with your decision.

Ker1hay

Hello, another update: The Radiologist did not think it was necessary to try ultrasound guided biopsies on 3 very small areas found on MRI, because no corresponding areas were found with ultrasound. But today, my surgeon wants those areas biopsied using MRI . So, before this I plan to have an appointment with a Radiation oncologist to discuss risks . Otherwise there is a skin sparing mastectomy my surgeon does..has anyone heard of that?
Before I posted here, I’ve been reading many of the posts for a week and my heart goes out to women struggling especially with the really hard diagnoses. 7 years ago I had a really difficult time even though it was a simple diagnosis- and my husband was also pretty sick with undiagnosed angina pain and other issues for years. He’s now cured with CABG surgery ( among other things!) about 3 years ago and I have more support this time around. Also having a specialist Dr makes a big difference. Glad to have this group! Thanks for all your replies.

NoBananas

i just met with my RO yesterday, and she explained the damage that could be done to my heart. I have had a bi-lateral mastectomy, and the idea of radiation plus Herceptin does not appeal to me. I have a good heart, but don’t like the idea of a shortened life due to heart problems, that can’t be repaired.

Mountainlover

Hello Ker1Hay,

I had a nipple and skin sparing left side mastectomy with TE placement last year. The initial plan was lumpectomy and radiation but other masses were found in MRI so a MX became necessary (but no chemo, no radiotherapy). Covid has delayed surgeries here so my implant exchange will only take place in summer, but am just out of a first round of fat grafting. There are many posts here on this technique but do not hesitate to ask/PM It you have questions or curiosities.

All the best!

LivinLife

I have scleroderma and radiation would have had even more negative impact on my heart and lungs already compromised by scleroderma so I was told (initially by rheum) I could not have radiation. I met with Radiation Oncology just to do my due diligence and the doc there was quite honest in risks to heart esp. At the same time they have come along way in minimizing the negative impact over the years. So being 58 that left me with mastectomy as my only effective option....

cangold

I had a left mastectomy on 2/5/21, went and saw a RO yesterday and he stated this will not effect my heart. Since I had 2/12 in lymph nodes he recommends it. Without it 15-20% recurrence with it 5-10% recurrence. I believe I'll do it.

LillyIsHere

Key1hey, I had skin and nipple sparing BMX in 2019. Cancer was found on my left side. I was recommended for lumpectomy+radiation and I did choose BMX because I believe once the breast creates cancer once, has the right environment for recurrence. I was told that the team decided no radiation because the damage will outweigh the benefit. I hope they are right because I have 2 positive nodes. The guidelines keep changing and what is state of the art today is outdated in the near future. I do agree with Salamandra.

Ker1hay

cangold, this sounds like the right choice for you, and sounds like you will have state of art radiation services too, hope all goes well

Ker1hay

thank you all for your replies, it really helps with my decision

NoBananas

Key1hay, I will be having rads on my left mastectomy side in a couple of months. They will be using the Proton beam. Have you heard of that

Ker1hay

Nobananas, I have no heard of that, I’ll ask when I see the RO this week, did your Dr say how they can minimize any effects on the heart? I pray it goes well for you

NoBananas

Ker1hay, apparently this radiotherapy is stronger, but has a better outcome as far as hitting the heart. It’s better targeted. But, this is the procedure - they give you a scuba like tube that they get you to bite between your teeth, and you breathe oxygen in till your lungs are filled. Hold your breath for 15 seconds while they bombard you with the protons. The idea is to move your heart away from the beams. All this while you are located in the tunnel. Some people mentally cannot do this, and in some cases, there may not be much difference between somebody’s full lungs, to hold away from the heart. Either way, soundslike the lungs will get a beating.

Ker1hay

No bananas thanks for your info. I think I’ve seen a video on that breathing technique. A friend of mine sent a website of Dr Lederman in New York who does Radiosurgery which is very targeted , doubt I’d go for that but it has way less side effects ( if indeed it’s a real treatment, I don’t know if it’s been addressed here on this site)but she said Jimmy Carter had gone there too

frab685

Newly diagnosed with dcis, left breast. No lymphnode involvement. Thank goodness. Scheduled for shortened radiation therapy. Scared out of my mind.Please advise. Thanks for your time. Also new to this group. Hi how is everyone.

Salamandra

Hey frab685,

A new diagnosis will always be startling. My advice is to connect to a breast cancer social worker or therapist, possibly through your treatment center or an organization like Sharsheret. They can be so helpful for understanding and supporting medical issues, social issues, insurance issues, economic issues, etc.

Have you met your oncologist yet?

DCIS is sometimes considered precancer rather than cancer. In the realm of cancer, it's an excellent diagnosis to have, and hopefully shouldn't be that scary when you've had some time to emotionally adjust. It will not kill/debilitate you now. With good treatment, the chances that it will eventually kill/debilitate you are also low, and honestly, as women we were always at risk for breast cancer, and as humans we are always at risk. We just sometimes get to ignore it for longer periods.

The important thing right now is to take care of yourself mentally and emotionally and show up for treatment so your team can treat you physically. I found (with stage 1 cancer) it turned out to be much more of a mental ordeal than a physical one anyway.

Good luck and hang in there!

LivinLife

Hi frab! As Salamandra said DCIS is precancer or preinvasive cancer (can't live outside the milk ducts) so this is the best of the "cancer" diagnoses..... Medical folks take it seriously (and should) b/c it can evolve into invasive cancer in many cases... hence surgery and oftentimes radiation.... Your onc may recommend hormone treatment as well depending on your ER/PR percentages... You truly will settle into this emotionally once you start treatment - it is so shocking early on, there is much to learn, many appointments, hurry up and wait, etc. Once you get a plan it will help you a lot. You will see it said on here you don't have to be brave you just have to show up. You can do this! We are here!

Ker1hay

hello Frab685, I had the DCIS on rt side 7 years ago and had lumpectomy( partial mastectomy) and regular radiation. It all went well, just a little skin reaction . At first I had so much anxiety about it, and partially because I wasn’t seeing a breast surgeon at first and the oncologist ( which I switched after switching surgeons) said I should have a double mastectomy and reconstruction , which was way overkill for what I had and not a better cure according to the breast surgeon. Now I have DCIS on the Left side and had partial mastectomy and will do the shortened radiation in a week. I was so concerned about heart damage but when I met with the radiation oncologist she said there would be no involvement of my heart at all and just very little of the lung. I really think having the radiation is good because it will kill any stray cancer cells. And radiation techniques are safer now . I wish you well in your treatments