radiation after mastectomy

Nikola

I will be curious to hear the responses you get.  I also had a mastectomy and chemo.  I saw my BS today and he started down the path of saying I didn't need radiation if I didn't want it.  I had 4 lymphn nodes that were positive and one tumor was only .5mm from my chest wall.  I insisted that he still give me the rad onc referral.  I have that consult next week.   I am anxious to hear what they have to say because like you I want to be sure I do everything I can.  I didn't have oncotype done because I was staged at IIIa and they don't do it for stage III & IV.

I have decided if they don't recommend radiation on the consult I am going to get a second opinion.  Just a thought for you - usually second opinions don't cost anything and it might give you peace of mind.

Either way, I will be anxious to see what other responses you get.

I had a mast, chemo & rads.  The reason for the rads was quite specific.  I had a positive node with extracapsular extension (bc growing out of the node), and I also had a 1mm, unspecified margin because of a tiny "surprise" bc lesion my BS didn't know about.  It was only found during the final pathology, so the margins on that little bit of tissue had not been inked, and there was no way to tell at that point what it had been 1mm from. 

So, from my experience, I would be concerned if you have specific things like this in your pathology.  Nikola, in your situation, if you have lingering concerns about what you've been told, maybe get a second opinion, just to ease your mind.  Jackie, I think your situation sounds like you would benefit from RT, but I'm not a doctor, and am just basing my opinion on my own experience and because of it, would be concerned enough about a .5mm margin against a chest wall to want RT.     Deanna

Nikola, from what I understand, research does not show any better outcome with rads with fewer than 3 nodes involved, so unless you had unclear margins I would say the recommendation for no rads is standard for your situation. Oncotype testing would not make a difference for this decision since it only shows how your particular tumor would benefit from chemo.

Jackie, your situation is very different. With 4 nodes involved and close margins I would be surprised if the rad onc doesn't recommend rads for you. And, yes, in your situation if it's not recommended you will do well to get a second opinion. Remember, a surgeon's job is to do surgery. Have you been dealing with a med onc at all? Who prescribed your chemo?

Best of luck to both of you.

Leah

Thank you everyone!  I feel better getting your feedback and it sounds like Nikola does as well. 

Leah- yes I am working with a medical onc who is doing the chemo.  I am in a clinical trial as well so I have a great clinical nurse that works with me as well. 

The rad onc office has already called and scheduled my consult for next week.  I will keep you all posted on how that goes.  I have #6 Taxol this week which puts me half way through