Trying to make a decision about radiation

Do it. 

survivability stats are based on lumpectomy with radiation. period. chemo was your optional treatment, not radiation. you are having chemo, from what i studied, because of the nodes. if you had no node involvement, you would still have radiation. The amount of radiation is flexible. Why not do everything now to prevent a recurrance? Learn, on this site, about regional and systemic treatments. Radiation and chemo are not treating you for the same thing, to put it simply. You can have radiation only once in an area of your body but can redo chemo treatment repeatedly. Lastly, stand your ground and make your radiation daily treatment when it is convenient for you.

radiation is standard with lumpectomy.  If you want to go back and do a MX then you could opt out of radiation.  Otherwise you need it and I can't believe your MO told you you did not.

Do it!!!

Even if you have 1 positive node the standard protocol is rads.

And change your Dr.

Good luck.The rads are not that bad.

hugggggggggggs K

Hello,

Posting my experience:

I'm not triple neg, as you can see, but also had an SNB + lumpectomy in July after neo-adj chemo. Surgery n° 2: lower axillary node dissection in August, we thought it safer as the SN had about twenty isolated tumor cells (not even micrometastasis), my surgeon took five additional nodes, all clear. 

Then my radiologist, surgeon and oncologist were in a meeting discussing radiotherapy for me; my radiotherapist wanted me to have:

-radiation to the clavicular area

-radiation to the internal mammary chain

-whole breast radiation

for 8 weeks + boosts.

My protocol after appointments with all three separately changed later on before I started rads.  I expressed my concerns for cardiotoxicity (accumulation of anthracyclines & alkylant agents in chemo + radiation=slightly increased risk for long term complications) and secondary cancers (leukemia for example). I also pointed out that there is no consensus on whether one should have the IMC irradiated if one has less than 3-4 cancerous nodes. I finally got the protocol changed to whole breast radiation for 5 weeks. Standard. I did not approve of the 'one size fits all' approach my docs have. I expressed my dismay that I might have been overtreated if I hadn't done my own research and argumented, because my oncologist also thought it was overkill in my case after having presented my arguments, and it is not often we agree on things :-) Every case is personal, I'm only suggesting that we should do additional research ourselves.

The 5 week protocol is standard. I believe because of my young age they wanted to do as with chemo: give me the most of it all, although this might mean severe complications later on..Or as my radiologist so nicely said 'Well, you have already had breastcancer at 29, so you'll surely get others, secondary or not'. Thanks alot. In his defense, he listened to me and without me asking decided I shouldn't get the rads tattoos. Thank you very much. 

I agree that rads are far 'better' than chemo, but only because one doesn't feel or suffer from the side effects doesn't make radiation to certain areas harmless, especially if we think long-term. Your cancer is triple negative thus very aggressive I suppose, so perhaps you really need every treatment offered.  What kind of radiation did your onc say it's ok to say no to? Maybe he was talking about the different areas being radiated? I didn't interpret it like he said you don't need rads, he said it's ok to say no right? Maybe you should ask him again why he said that, on what grounds he based his words you know? The thing about radiation if one has 3-4 positive nodes applies to radiation the the IMC & clavicualr area as far as I have been informed, so maybe that was what he meant? I know women who refuse rads in Europe get treated like they have plague or something, so I think it's nice that your doc says it's ok to say no, although one should know why! Taking informed decisions should be mandatory. 

 I got 4xFEC (anthracyclines- as is adriamycin- & alkylants) and 4xTaxo dense dose. I know there might be a risk of downstaging having received neo-adj chemo, but my onc explained that the most classic case scenario is invaded axillary nodes at first, and then they 'move on' to the clavicular area, so I could be calm in my decision not having the clavicular area treated. Radiation to these parts may result in hypothyroidism he explained.

Personally I had a very, very, very hard time deciding whether or not I should skip radiation all together. I opted for the whole breast radiation only, which makes me less pessimistic about the future and secondary cancers because I really want to limit overtreatment. I made my decision after careful discussions with all of my doctors mind you. I know I need rads as I opted for lumpectomy. Radiation to the axillary area over here is a big no-no after a node dissection as it increases the risk of lymphedema and additional nerv damage. So, if you are anxious about rads, check out your personal protocol, and do additional research for your personal case, and ask ask ask. 

A nurse who gave me the nano radioactive injection before my SNB told me 'Radiation cures more than it kills' and that stuck with me. Best of luck to you. 

I have had triple negative cancer twice now.  The first time I had Stage I and had a lumpectomy, SNB with no nodes positive and a re-excision several weeks later to clean up margins.  I had radiation and there was no conversation about this being a "maybe."  It is my understanding that if one has invasive breast cancer and a lumpectomy, one must have radiation.  Sometimes depending on tumor size and node status, you can get away with no rads if one has a mastectomy.  I can't believe your oncologist thinks you can forego radiation, but of course this isn't his area of expertise.  Because of your age and triple negative status (more aggressive) I would definitely do the radiation.  I found it, unlike chemo, to be extremely easy.  A little tiredness but nothing bad.  Good luck to you.

Did anyone see NBC Nightly News tonight?  Brian Williams interviewed Dr. Dupree, a breast cancer specialist.  I forgot where she practices.  Anyway, she claimed that radiation had systemic as well as local value in reducing the recurrences of breast cancer.