optimal timing for radiation therapy after mastectomy

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shakti
shakti Member Posts: 4
edited June 2014 in Radiation Therapy - Before, During, and After

Hi-

I completed 24 weeks of neoadjuvant chemotherapy in December, then had a mastectomy with axilla block dissection 2 weeks ago. 

Wondering about optimal window for start of radiation therapy.  Will appreciate any infomation on this.

 Best-

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  • dlb823
    dlb823 Member Posts: 9,430
    edited January 2011

    Hi, shakti ~ I don't know why your question seems to have slipped through the cracks, but I'm going to respond, mostly to bump it for you.  I had chemo after my surgeries, and could have started rads 6 weeks after chemo ended, which would have been December 1.  Due to vacations and a reduced holiday schedule, they actually waited to start me until Jan. 1, which was 10 weeks.  So I think there's some leeway, depending on how fast you're healed, etc. 

    Hopefully others who had your treatment sequence will now see this and respond.   Take care ~  Deanna   

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  • Letlet
    Letlet Member Posts: 1,053
    edited January 2011

    shakti, i am not in your situation either. I am finishing chemo and will get my exchange surgery next month and they want me to wait 4 weeks to heal before starting rads.

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  • shakti
    shakti Member Posts: 4
    edited January 2011

    Thank you so much Deanna.  This is very helpful. 

     Best wishes,

     Shakti. 

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  • shakti
    shakti Member Posts: 4
    edited January 2011

    Hi Letlet, thank you for your response.  Good luck to you with your treatment.

    Best,

    -Shakti.

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  • shells43
    shells43 Member Posts: 1,022
    edited January 2011

    Shakti, I had my chemo every 3 weeks and then went right into rads 3 weeks after the last chemo. It seems there is no hard and fast rule as for the timing. Good luck!

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  • Heidihill
    Heidihill Member Posts: 5,476
    edited January 2011

    According to a study at Dana-Farber delaying rads to after six weeks from surgery inreases risk of recurrence in older women. The author is R. Punglia, so you can google fr more details.

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  • bdavis
    bdavis Member Posts: 6,201
    edited January 2011

    I have a question... Why radiation if you had a mastectomy??  I thought it was one OR the other.

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  • Houndmommy
    Houndmommy Member Posts: 377
    edited January 2011

    bdavis - some folks (like me) still have to have rads after a mx due to margins not being clear. 

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  • Marjas02
    Marjas02 Member Posts: 6
    edited January 2011

    I had a bmx with clear margins but my oncologist and radiation oncologist both recommend radiation due to the fact that the original size of my tumor being 8 cm.   According to my radiation oncologist, even though there isn't any breast tissue to radiate, she wants to radiate my skin and chest wall.

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  • Letlet
    Letlet Member Posts: 1,053
    edited February 2011

    bdavis, my surgeon told me because I had 6 positive nodes I would definitely need radiation. Believe me I felt so betrayed because he told me that I would not need radiation after a mastectomy and here he was telling me at my post-op otherwise.

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  • Alyad
    Alyad Member Posts: 817
    edited February 2011

    because you had neoadjuvant chemo and then a mast, not ws many women have the same set of circumstances- I had a skin sparing mast  and immediate recon. I was in a grey area of whether to do rads, so I went out of town for a consult- that delayed my rads to about 7 weeks post last chemo. Another potential reasons to do rads (other than having 4+ nodes, where rads is considered automatic) - if you are in the 1-3 grey zone like I was- if you had a small number of nodes removed, premenopausal, if you had a tumor in the inner quadrant (chance of undetected spread to intramammary nodes), there are probably other reasons. I had my skin , chest wall, axial and mammary nodes zapped

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  • shakti
    shakti Member Posts: 4
    edited February 2011

    Hi everyone,

    Thank you so much for your responses to my post.  

    Bdavis, I need radiation because PET and MRI scans done at the time of my diagnosis indicated potential involvement of the internal mammary/subclavicular lymph glands.  Since, these lymph nodes are not tackled by the surgery, radiation is recommended for these fields, in addition to the chest wall and level 3 axillary area.

    I am planning to start radiation 5 weeks from the surgery date. It appears that most radiation oncologists want to wait at least 4 weeks post-mastectomy but not longer than 6 weeks.

    Best-

    Shakti

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  • GrandmaBubba
    GrandmaBubba Member Posts: 111
    edited February 2011

    Shakti

    I had neoadjuvant therapy finished in August. Due to scheduling problems BMX w/TE's mid-November. Then 2 debridement surgeries, the last on 12/13. Was told optimal window was within 6 weeks of surgery. Since I still had open skin areas until 3 weeks ago we're now trying to get fills done. I haven't talked to the dr, but her we may have to stop fills until after rad finished. Set-up appointment 2/21. Probably start tx week after that. Really don't want to do this. I'm tired of it all. I've been doing this since dx in April 10.

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