Radiation Necessary

I would get another opinion, i went to 3 different radiation docs, in hopes of getting "you don't need rads."  but it wasn't the case all 3 said get it, so i did.  yours is so small I am surprised they suggest it, but i would get another opinion then decide , you can say no  even if they suggest it, there are several here that turned it down.  its all up to you.

It's my understanding that if you have a lumpectomy rather than a mastectomy, they prefer to radiate the remaining breast and especially the "tumour bed" to avoid cancer growing back in the same area (it only takes one rogue cell!).

It also depends on the size of your tumour as well as the pathology of the cancer.  For me, even if I chose to have a mastectomy, because the cancer was an aggressive grade 3 and Her2+++, they wanted to do rads.

It really wasn't bad. MUCH easier than chemo, and I guess for me, at least I know that I have done all that I can.

While I'm still having TCH right now, I too am questioning RADS in my situation.  I haven't totally ruled it out mind you, I just need to see some evidence that it isn't overkill.  I also had an MX, but the margin was 17 mm from the tumor site and 11.2 from any DCIS, no nodal involvment.  Once done chemo,  will revisit the with the RO.  I am also going to do Herceptin for a year in total and an AI for 5 years after that.  What I struggle with is will the benefit outweigh the risks for me.

Although, I can't say I would feel the same way with a lumpectomy though in all honesty.

Carrye

Thanks for the arcticle.  I just read it.  Again like I said in my previous post to marystnow, I would feel differently had I had breast conserving surgury and of course nodal involvment.  And while I haven't totally ruled it out in my situation, I need more info from my RO when its time to re-visit after my chemo TX.  As it stands now from a statistics perspective for me, it gives me approximatley a 5% better chance on no reoccurance, therefore 90% vis 95% with no RADS provided I continue with Herceptin and whatever they deem is the correct AI for me for 5 years as well.

My heart goes out to you Alcie1. I refused radiation because of what you just said. The rads onc was so sure I needed it from DCIS in an odd area. The cancer team had not seen a case like mine and all said "get rads." I had a uni RMX and said no to radiation and chemo. I am almost 55 and literally lived with DCIS for 17 years before they found a tiny IDC, 4mm. Johns Hopkins said it was 1mm. My oncotype DX gave me a score of 15, so I refused chemo. I am taking tamoxifen. My neighbor had rads on his leg and they over radiated him and it will never heal. He's fighting infection constantly and is suing the center. His leg looks like black shoe leather. Sorry, not for me.

Lawrence,

Very sorry to hear about your wife. You may want to check out the article (study) from UCLA.

http://www.cancer.ucla.edu/Index.aspx?page=644&recordid=560&returnURL=%2Findex.aspx

I became concerned when I read this, but realize radiation can help and has helped thousands of women. I fear radiation so I will not be partaking in the treatment. As you stated,  the cure can be worse than the disease, but that depends on the severity of the disease. Positive healing thoughts to your wife, may she beat this thing and come out healthy!

I no longer see the study about Radiation causing cancer stem cells to grow. Maybe it scared too many women who were to get radiation. 

Mary,

I 100% understand what you are saying. And, yes, I realize that a lumpectomy is "supposed to be" followed by radiation. However, I am wondering exactly the same thing, and no one has been able to give me an answe that makes sense. - If one has chemo following surgery (I did chemo because of grade 3 and high oncotest score), then why does require additional treatment with radiation, too?!



Chemo is supposed to kill or stop cancer cells from growing further (depending on the chemo), and it targets the entire body, right?! So is the breast not also part of that entire body?! Therefore chemo should also kill any stray cells left over in the breast and avoid local recurrance, shouldnt it?! - For me it's really hard hard choice to make, given that my RO (who is also a professor and practices at a NCI designated center) told me there is NO WAY to completely avoid the heart and part of the lungs, if they were to radiate my left breast.



So with a relatively small cancer, clean margins and clear sentinel lymph nodes, as of right now I think the rsik/benefit is simply not in favor of radiation. In my case, that is. I am keeping an open mind and have a bit over 3 weeks to make up my mind. For now, I am looking forward to completing chemo in two days. What a ride it has been - but glad I did that part. Yay!!!!

I am NOT having rads despite having 4 mm of cancer on 1 of 2 nodes removed. My surgeon, who is considered the best in the area, thinks that there are too many long term risks for a nebulous benefit, esp. when cancer is on heart side, as mine is, and you are young (45). One very young rad onc said yes, another older, very experienced rad onc said "there are no bad choices" and told me her board thought the risks don't outweigh the benefits. I may have a level one dissection, but other than that am willing to see if tamoxifen does its job. Chemo already put a strain on my body without much benefit for a Grade 1 tumor, and I fear the study that says rads can turn a low grade tumor into a higher one, if it comes back.

I chose BMX. I was terrified of radiation and didn't need it with that surgery.  I am thrilled with my decision.

I have communication issues with my RO as well.  My MO is great though. Long story short I met with her at the beginning of the process in January after my MX.  Of course she recommends radiation but we will meet again after I finish chemo to discuss further as she wants to present my case to the tumor board first regardless.  I finish chemo on April 20th and meet with her on the 26th.  Of course since January I have had alot of time to research and nowhere can I find where its indicated with my pathology including NCCN (I'm in Canada). 

So we meet and she hasn't presented my case and still wants me to do RADS because of my HER status, grade and tumor location "near the chest wall".  I correct her and tell her they were centrally located.  "oh you're right".  Says she also wants to talk to my surgeon, has the wrong surgeon's name.   I correct her.  I come right out and ask her if she can point to a study or Canadian guideline where RADS would be indicated?  "no".  I felt like asking her what she was smoking or if she had the correct file. She ends the meeting with "I'm glad you read"?  So once again she says she will present to the board and we are to meet again in a week.  I already know what my MO and the Sr MO's opinion are (no rads) along with my surgeon (no Rads).  I don't have alot of faith in this doctor to make a decision to save her life.  BTW I'm not doing rads but wanted to give her the courtesy of listening to what her opinion was along with the rest of the board.

c-squared and Gracie... you both sound like me except I had IDC not ILC... I had one positive node (.38mm) so super small... but even if it had been one full node, or even 2 full nodes, the doctor said no rads was necessary. Now, my tumor was way up by the skin and they got clear margins. No extra nodes were taken, and even when I asked them to take more, they all said not necessary (Not the standard of care).

Betsy and C-squared, thanks for the info, altho I know this is a thread on rads, I am scheduled for a level one dissection in less than two weeks--BS says if it makes me feel better he'll do it, but I am wondering if risk outweighs benefits and if indeed, in the future, the new standard of care for MX with less than 3 sentinel nodes will also be no ALND. Where are you two being treated?

I am being treated in the northern suburbs of Chicago, IL

All I know is what I have been told, that with a MX and less than 3 nodes, radiation is not necessary.. BUT you have ILC, which might be different than IDC... not sure.

My docs said no radiation for me......with two positive nodes.  I had small tumors, no LVI, great margins.  The risks outweighted the benefit for me.   I did have two other opinions......one other RO said "no" and one said "yes". 

My hospital is the headquarters of the NSABP and that is their protocol.....it is actually 4 or more positive = radiation. 

I need to move on....I've been racking my brain over this for weeks.  I have to trust my team.