Double LX, having trouble deciding about Rads

bluegentian
bluegentian Member Posts: 13
edited June 2014 in Radiation Therapy - Before, During, and After
I am feeling unsettled about my decision not to have rads. Two ROs told me I wasn't a very good candidate - large breasts, two LX at once, the larger tumor, dcis grade 2-3 with comedo in the left breast close to my heart, I am 68, I have a history of near fatal strep pneumonia, and my mother and grandmother died of lung cancer (non-smokers...) I have my lumpectomies the day before Thanksgiving. My surgeon wasn't too happy with the first RO saying rads wouldn't be that good for me, so she sent me to another, whose picture was the same. I know that the first step is getting the pathology results of these two LX. If the feeling is still strong that I should have rads, I have discovered MammoSite. I would have to travel to a different city to get it and I know it must be done soon (weeks?). Has anyone had MammoSite or Savi or IMRT on two breasts at the same time? I know another option is double mastectomies. I am hoping for clean margins, no further dcis, and no rads. These decisions are really hard ones for me. I would love to hear from anyone struggling with rads or no rads, double lumpx, MammoSite or Savi on two breasts at once. (I feel like I am in a very small group with double LX, hoping for no rads...maybe not? I was told that only 3% of DCIS is detected in two breasts at the same time...)
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  • cycle-path
    cycle-path Member Posts: 1,502
    edited November 2011

    In addition to WBI (whole breast irradiation, the "usual" thing) and PBI (partial breast irradiation via Mammosite, Savi, etc), there's also IORT.

    IORT (intraoperative radiation therapy) is a little like Mammosite in that a balloon-shaped device is inserted into the breast and the radiation is delivered right to the tumor bed, saving the skin and other organs. The difference is that with IORT it's done during surgery.  While your incision is open a round radiation source is placed inside the tumor bed. The radiation is administered and the incision is closed.

    That's it. It's a one-shot deal. No side effects other than some fatigue, which is unavoidable when radiation is concerned. The only problem with it is that its availability is pretty limited.

    If you're interested you can post your location and I may be able to find a center that provides it. As I say, they're pretty limited.

    http://www.zeiss.com/C1256CAC0038CEFF/ContainerTitel/Radiotherapy/$File/patients3_2.html 

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  • bluegentian
    bluegentian Member Posts: 13
    edited November 2011

    Thanks, cycle-path. My surgery is the day after tomorrow and I know this isn't an option where I am having surgery. I have spent so much time driving 130 miles each way for appointments and biopsies, I reached the point where I decided "I just have to do this now" so I scheduled the double LX. I understand MammoSite is done in Minneapolis, a mere 250 miles from where I live, or the Mayo Clinic.

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  • tarry
    tarry Member Posts: 156
    edited November 2011

    I'd go to a major center and get a second opinion. The idea that one breast is ok, but two are not doesnn't sit well with me somehow.



    At MD anderson you could get the Canadian 4 week schedule. A Lot of women come and stay in houston. After xmas might be just right, and Jan will be sometimes warm and sunny.

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  • cycle-path
    cycle-path Member Posts: 1,502
    edited November 2011

    bluegentian, you don't say where you live but apparently you're in the general vicinity of Minneapolis. I checked on the hospitals that do IORT within about a 250 mile radius of Minneapolis, and they seem to be the Nebraska Medical Center at the University of Nebraska, and the University of Wisconsin.

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  • bluegentian
    bluegentian Member Posts: 13
    edited November 2011

    I live almost on the Canadian border in Minnesota. The closest breast center is in Duluth, Mn. So that is where I have scheduled my LXs. I've been very happy with the surgeon, it has been the radiation issues that have snarled up.

    I know that in Minneapolis and at the Mayo Clinic they have the MammoSite and IMRT, both they say are better for large breasts and for avoiding lungs and heart, but have not consulted so don't know how they look at bilateral. At this point it seems taking the chance that tumors are small and wide margins are good by doing the LX is step one. I am most anxious about the week following- waiting for the pathology. If all is well, I may be able to join the women who forego RADS. If not? So much uncertainty on this journey.

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