Decision on Radiation

Options
Mandamoo
Mandamoo Member Posts: 8
edited June 2014 in HER2+ (Positive) Breast Cancer

Hi - I'm a newbie from Australia.

I am 38. I had a LMX (skin sparing with tissue expander) in March and an axilla clearance. 2/14 nodes positive, largest tumor 2.2cm (2 much smaller tumors and a 9cm area of DCIS).  I m ER/PR -ve and Her2+ve.  My Chemo is 3*FEC and 3*Taxotere and Herceptin (docetaxol) - I have 2 to go and will continue Herceptin for another 14 infusions.  

My breast surgeon says I do not need radiation as my tumor is under 5cm and only 2 nodes positive.  No sign of Lymphovascular invasion.   I notice the American guidelines indicate radiation for anyone under 40 with positive nodes - they do not have this guideline here.

I saw a radiation oncologist yesterday and she said it was my decisionas I am in the "grey zone" - that the risk of local recurrence was 10-15% and radiation would reduce this my 2/3.  I did not find this argument compelling.  My husband is keen for me to give it all we can to reduce the risk of any recurrence. (I have been told my risk of secondaries is 10% after the chemo and surgery).

It will delay my planned reconstruction considerably (Which doesn't bother me too much) and I can deal with the inconvenience - I've written the year off anyway.  I am aware of the slight lung and heart risks too.  

I am interested in others' experience with radiation after mastectomy - did you do it? What other things are worth considering?

Thankyou

Amanda  

· Share on FacebookShare on Twitter

Comments

  • Iamstronger
    Iamstronger Member Posts: 378
    edited June 2011

    Hi mandamoo. I too was considered to be in the grey zone. I saw two more radiologist once and they both recommended radiation. But, we modified it by radiating the tumor spots and not the superclavical. They thought that since I was young and it pos her2 that I should have rads.



    For me, I wanted to know that I did absolutely everything possible for my young kids-2&3 yo boys.



    Sometimes being in the grey zone is more difficult. Good luck on whatever you decide.

    V

    · Share on FacebookShare on Twitter
  • Slainte
    Slainte Member Posts: 152
    edited June 2011

    I am in a similar situation. I am 45 with LMX 1/18 LN pos , Er/Pr neg her2+. My tumour is grade 3. I finished chemo FEC d (t) on Jan 24th. My rad Onc said I didn't need chemo as I had only 1 LN involved. A new study has just been real eased from mcmaster university in Canada ( I'm canadian so it made the globe and mail, you can google it) which was targeted at people in our position. Early stage breast cancer with 1 to 3 LN inviolved concerning axial radiation. There was a decrease in distant spread with axialla radiation. I'm waiting to hear back from my rad Onc right now to see what this study really reveiled and whether or not rad is recommended for me , especially since it has been 4 months since I finished chemo ( I'm still on herceptin). This paper was presented at a oncology conference in Chicago a few weeks ago. Ask yiou radiation oncologist their opinion on the study.



    Good luck in you quest,

    Christine

    · Share on FacebookShare on Twitter
  • Mandamoo
    Mandamoo Member Posts: 8
    edited June 2011

    Thankyou Christine and vmarie - I have decided after talking to numerous people, reading up and family considerations to go ahead.  This new research seems to have the oncologists excited but still not my surgeon.  I think he feels its a lot to go through for a lower risk.  The oncs all seem to think my age, Her2 status, and multifocality are indicators for going ahead.  So I am.Just a little more disruption to an already disrupted year!

    Thanks for your responses.

    Amanda x 

    · Share on FacebookShare on Twitter
  • CarylC
    CarylC Member Posts: 230
    edited June 2011

    Mandamoo, I am older than you (50) but like you, my surgeon said no radiation but my oncs (I interviewed with a local well-known teaching hospital first, then a local doctor) both said absolutely yes to radiation.  I did have lymphovascular invasion and extracapsular extension in my nodes so I don't know if that made the difference but I feel like why take the chance?  I'm giving up this year to healing.

    · Share on FacebookShare on Twitter
  • Mandamoo
    Mandamoo Member Posts: 8
    edited June 2011

    Good Idea I think Carol.  I have had a dramatic chance in circumstances this week though.  A lesion on my breast had started to grow (on the mastectomy side) - a biopsy showed it to be the cancer and a PET scan has showed secondaries on my lungs and in a node near my next.  Radiation is actually not an option - we are waiting to work out now what my treatment options are.  I am devastated as this has happened while on chemo - I had clear scans prior. 

    Go with your gut on the treatment and give it all you can!

    Amanda x 

    · Share on FacebookShare on Twitter
  • Iamstronger
    Iamstronger Member Posts: 378
    edited June 2011

    Amanda,

    You are in my thoughts and prayers.  Super big hugs to you.  I f'in HATE cancer!

    V

    · Share on FacebookShare on Twitter
  • duckyb1
    duckyb1 Member Posts: 13,369
    edited June 2011

    Mandamoo...............I had a lumpectomy.......I am 76.......everything in my favor........they did tell me I could forgo radiation (MO said that) because of my age......................The RO said, "no you can't", its not worth the risk.

    Well I did it, and I got 36 treatments which included 8 boosts............I sailed through.........of course I got some redness (never hurt though)............never got tired...............swelled just a little...........I was at a cancer center with expert treatment...............I'm not saying some don't have a tough time with Rads.....................I was one who didn't, and just wanted you to know.....................also I am blonde haired, blue eyed, and my RO, called me her Poster Child for Rads ........................she expeced me to "fry"......................I didn't........good luck

    · Share on FacebookShare on Twitter

Categories