Stage IIB, had bilat mast- should I do rads? Did you?

What does your radiation onc say?  I had similar varied opinions after my unilateral mast, but the rad onc I ended up using pointed out to me that taking advice on rads from my local onc (my one "no" vote), would be like her telling me not to do chemo -- technically, not her area of expertise, especially in a "gray" situation.

If you've had a "yes" from a rad onc, I would pin them down on the specific concerns about your surgical pathology that make him/her believe RT is in your best interest.  In my case, I had an unspecified close margin, as well as extracapsular extension in my positive node -- both things I had a better understanding about after they were explained to me.  The rad onc I chose was also able to allay my concerns about heart/lung damage and LE.

I tried very hard to find support not to do RT, but in the end, I did it, and it wasn't any big deal -- far easier than chemo.    

Good luck making a decision you feel good about.   Deanna

I was stage 2B also - had neoadjuvant treatment as well, which shrunk a 4cm tumor down to less than 6mm. My 2 nodes that were definitely positive prior to treatment via PET and US both came back negative as well as the other 10 they took out. My medical onc said it was up to me, my rad onc said it was up to me, my surgical onc said "I would". I was 37 at dx with a new baby. I decided to do rads because I wanted to do everything that was within my power to never have to go through treatment again and to raise my baby. Of course, there are never guarantees and I do often wonder if I wouldn't have developed LE if I didn't do rads, BUT my priority was to live and so far I am doing that. It is a very personal decision and ultimately you will be the one deciding. Good luck in whichever choice you make.

I am wondering too. I also hear if nodes are positive you should do rads. I also hear if your tumor is larger than 5cm then they recommend rads even with mastectomy. I have clear margins, 5.5cm no nodes. Meet with oncologist tomorrow. I'm hoping I don't need rads but my tumor is/was grade 3 & HER2+ (aggressive) so they may want to be more aggressive. So far they have been very aggressive with me but I know I'm really going to question the rads.

I didn't do chemo before. I'm glad I didn't. This way I know for sure they are not in my nodes. Of course now I don't know if the chemo will work but that's cancer. Glass is always half full and half empty.

I've worked with several women in our area to connect them to docs at Dana-Farber. I had this question come up recently and checked with my rad oncologist, an assistant professor at Harvard. She recommended standard radiation treatments for the lady I was inquiring for. She was under age 50. Age was a factor in my doc's opinion for the type of radiation she recommended.

  I was at risk for heart and lung damage. I'm doing well. (Praise the Lord!)

  Radiation is not that bad... It's more an inconvience than anything. Yeah, you're a little more tired than normal but for the peace of mind and the increased odds for survival I think it is worth it.

Kathy 

I would check with your oncologist about doing radiation after reconstruction.  I had a bilateral mastectomy and had the start the reconstruction process right away.  I am undergoing chemo and have been expanded twice already.  My oncologist told me there was a chance I would need radiation due to 2 of my nodes being positive and that it would have to be done before the final swap in the reconstruction because the radiation damages the implants.   Make sure your team, all involved know what is going and talk to each other.  Good Luck to you!

I definately agree with Nadine's comments about rad before ps. Tissue is changed by rads. Ask what your PS is willing to work with. I think that as women we often forget this is about saving our lives. Second, quality of life; third cosmetic appeal. When discussing reconstruction with my rad onc and making some of these tough choices about "when" to do "what" I captured that reality: "I am more than a breast" and "this is about saving my life, first!" I gave my rad onco the final decission based on what was in my best interest for saving my life. Some docs don't like to commit. I looked my docs straight in the eye and said, "For you... What if this was YOUR diagnosis? What would you choose?"

Another thing I found: my PS was able to remove some of the rad tissue during the reconstruction. That made me VERY happy.

Just read an article from a reliable source about studies conducted on rads. The article stated that the quicker rads for older women were started the more affective. This research trial may have been done on older women but having been a part of a clinical trial for H/T/C (staged 0- earlier 3) at Dana-Farber I know that a select group is chosen but finds cross lines to others. I had to travel 80 miles each way for app'ts. So glad I did!!

Kathy

I had BMX with TE and some fill. PS is doing 1 fill (today) and maybe some more before chemo. If I do Rads I will have to wait 6 months before any additional expanding/exchange.

My PS feels treating cancer is first. Cosmetic is second. Even on my surgery consent form it states "I understand that this operation is not an emergency nor is it medically necessary to improve or protect my physical health."

If you decide to delay radiation be sure you find out if that will reduce its effectiveness or not.