I have decided NOT to do radiation...

So long as you are aware you are going against medical advice and are assuming a significant risk of recurrence, its certainly your right to make such a choice. 

If your tumor is less than 1 cm and you have no positive nodes, then you are Stage I, not Stage II.  However, if you are really Grade 2, this means you have a more aggressive tumor and radiation would definitely be indicated. Another step you can take is to get the OncotypeDx test, which will tell you your risk for recurrence so you can make a better decision.

Good luck

Cheryl

I second ehall's suggestion to get a second opinion.  You need to have a good relationship with your rad onc, whether or not you decide to accept a recommendation.  Your rad onc should be able to tell you in clear language the risks and benefits of radiation to you, given your special health circumstances.  While radiation may be generally indicated for lumpectomy patients, your special circumstances may make you the exception, or as others have said, you may be a candidate for Mammosite or other less-common radiation procedures. 

You need to feel comfortable that the rad onc has taken into account your entire medical history and your personal feelings, not just the fact that you've had a lumpectomy.  Only you can determine how much risk you're willing to assume, but you need to know the facts about risks and benefits in your case. 

For me, I declined radiation after visits to two rad oncs.  The first was like your rad onc and took it personally.  I was not comfortable with him at all and did not feel he'd analyzed my entire case, so I sought out a second opinion.  The second one was wonderful, and after reviewing my entire case, agreed that I was a true borderline case, and it was quite reasonable for me to decline radiation.

I too have decided not to have radiation. I did lumpectomy with rads on the left nine years ago.  Now I have bc on the right.  Although highly recommended, I declined radiation for two reasons. One, the radiation waiting room is a very sad place to be.  While my prognosis is excellent, others there are fighting for their lives.  I felt guilty and sad. Guilty because I had a chance to live and sad because I could not help them.  The second reason is because I have breast implants. The radiation caused severe capsular contracture on the left.  I had the implants replaced but my cosmetic result in my opionion is poor.  I have been living with these water balloons for nine years and I HATE IT. Having radiation on the right is going to cause even worse cosmetic consequences.

I have been told many times that the reoccurance rate without radiation is 40 percent. I agree that is high.  But there is a 60 percent chance that I won't get it back.

I have not had the nodes evaluated yet.  That happens in three weeks.  Positive nodes would make me reconsider my decision. But as of now, no radiation for me.

We all can make our own decisions.

Orli,

I'm surprised that your onc is so dismissive of your history of systemic lupus.  In everything I read about radiation recommendations, SLE and scleroderma are mentioned as possible reasons NOT to recommend radiation.

I too am a little confused about your dx; as Cheryl Rubie said,  <1 cm with no affected nodes would appear to be Stage I.  Where I differ with CherylRubie is that I don't think Grade 2 automatically means you should have radiation.  As far as I know, Grade 2 is intermediate, Grade 3 would be more likely aggressive.

Radiation has been standard with lumpectomy, but there are studies ongoing to evaluate results of lumpectomy without rads for early-stage BC.

On the other hand, women with lupus who have more advanced BC have undergone rads successfully.

RubyTuesday is right -- ask for all your pathology reports, and get a second opinion.  Also -- do you see a rheumatologist regularly for your lupus?  This might also be someone with experience and helpful opinions, who has seen other SLE patients treated for cancer, and might have a recommendation for an oncologist who "works and plays well" with your rheumatologist!

Just look at your rate of re occurrence - then look at side effects to heart & other problems.  I have spent the last week researching  all of this (but for my dx) I had 2nd opin. oncol. 2 opin on rad. oncol. one said no - the other two spec. that got their hosp and cancer center  tumor boards to look at my close margins and I have a high grade , fast growing, etc...  cannot be treated with hormone treatment (er and pr neg.  large mass of DCIS tumor removed by lumpectomy  then mast)  Everyone is so different - get more that one opinion - learn from from us all.  Do not let one doctor make a guess, I have been injured, gotten sick from meds and employee mistakes at hospital too.  You have to take the time to do your homework on your indiv. dx and other health issues.  I have decided and 2 hosp tumor boards think I need rads, one doctor said no other treatment needed.  I do not want to have heart, lung, tissue damage to my expanders. So much to think about. But I am taking all this infor. and following my gut in stint and hope it goes to my advantage. I have long drive (1 hour) to and back to my rad for 6 weeks in Sept.   If it does not then there is plan B.  Good luck you will find many mentor and friends on this forum.  

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I know what you're talking about. I have severe asthma, to the point where my allergist and I have the "do I have asthma or chronic obstructive pulmonary disease (COPD)" every few years. And COPD contraindicates rads. Plus, the steroids and such I take for my lungs makes my bones more fragile than most.

Most trials are done on healthy women, and I genuinely believe that our doctors do the best they can with those who present with difficult cases, but I do feel that they often try to shoehorn those of us with early-stage breast cancer, like you and me, into easy-to-manage compartments. I'm still struggling with lung problems 3 months after rads, and he says they aren't serious, but I find them scary. If I had it to do over again, I would insist on better answers than don't worry about it. But I didn't. And that was my choice.

I did, however, get shirty about the arimidex. I'm on tamoxifen. The doctor couldn't give me answers that made me comfortable about the long term side effects it would have on me (because there is no data; it's still a new drug). And I'm already coping with too many complications.

Good luck. 

I would agree to seek out a second opinion, however, I can also agree with your not wanting rad.  I had lumpectomy and rad back in 06 and then DCIS recurrence in 07.  Because I had radiation I had to have a lat flap in order to accommodate the radiated skin when I needed a mastectomy.  So I had radiation and had a recurrence and then my mastectomy was more complicated. 

 The only thing I would worry about with you is that if travel for radiation is difficult, is travel for more aggressive screening difficult. I would think that if you are opting out of rad you should really have screening twice a year at least MRI/Mammo. 

I opted for No Tamox because I had a thickening of my uterin lining and didn't want to risk anything. 

Yeah! I'm so glad you are getting the support you needed

Orli, I am so glad that your GP is helping you through this maze.  I, too, relied on my GP.  She is wonderful, and the only one of my multiple doctors who is looking at the "whole picture" rather than a specific part.  I wasn't a candidate for radation, and opted for bi-lateral mastectomy.  I declined chemo because of the potential damage to my heart.  It just wasn't worth an additional 3% benefit to me.  The Arimidex gives me an additional 12% of non-recurrence over 5 years.  Adding the chemo might have been a good thing, but it seemed to me and my husband that the risks to my heart muscle, which is already compromised, weren't worth it. 

You are right, this is an amazing group of women.  And, the more information we have the better able we are to intelligently and realistically get on with our treatment and our lives.  Peace to all.

Orli - I think you are making a good decision.. It is nice to have support here as well as a good medical team on your side.

Best of luck to you as you continue to fight. this monster beast of a disease.