Boosts or no boosts

Mayanne · March 2014

I thought I was finished with my decisions. I was told at the planning meeting with the RO that I'd be having 33 radiation treatments. In retrospect, the RO knew I had reservations about the radiation, itself, because of my PVC's and he patiently explained about the plan and the blocks that would prevent heart damage. He probably didn't want to mention the boosts at that time, hoping I'd settle for one thing at a time.

Last week the tech handed me an appointment card for the sim appointment for what she explained was a targeted treatment to the site where the "tumor" had existed before surgery. I asked if this was for the "boosts" and she looked surprised that I knew the word and said that many women haven't heard the term and get "all worked up" about the idea of it (which always surprises me that some people have not done research). What she said also makes me believe that they expect some resistance.

I'm not sure what to think or whether boosts are always a good idea or if they are not necessary in certain cases of DCIS? I had two small areas of grade 3 cells in the same duct, close together and in total measuring almost 1cm. There was necrosis. I had clear margins but my path report did not mention the width. Hormone status is negative, but I know that is not always relevant with DCIS. However, in this case I can't take Tamoxifen. I am 65. I have had my 16th treatment on Friday of 33 total. Evidently, 5 are boosts, although I've yet to hear for sure.

I was wondering if other women with my profile have had boosts with radiation? Might it be overtreatment? Perhaps with the negative hormone status it's one more precaution against recurrence and not to be admitted if offered? BTW, I do have a family history of BC. My mother had BC and my sister does, also, however I had a full panel of genetic testing and out of 35 factors, all was negative (as of this time in medical history). I suppose it may also be this family history that is contributing to the caution. Also relevant is that I really like my RO and trust him. Just curious about your experiences, however and would appreciate any input.

redsox · March 2014

Boosts are generally given with electrons that do not penetrate very far and they are given to a smaller area around the tumor site. So the risks are low -- mostly more skin effects but virtually no risk to the body outside of the breast.

I had 6 boosts and the area of the boost was discolored more and for longer than the rest of the breast but it faded and now shows no difference from the rest of my breast. I researched everything thoroughly and I think boosts are low risk, uncertain reward. I was willing to leave it to the rad onc's discretion.

icebaby10 · March 2014

I had 28 whole breast and 8 boosts..

Mayanne · March 2014

Thank you, Redsox and Icebaby. I decided to go ahead with the boosts. Had the sim on Tuesday and will start in about a week. I appreciate your input!

Mommyathome · March 2014

I'm seeing a lot of people who were diagnosed with dcis are going through other treatments. Did you have a masectomy or bilateral mastecomy?

Beesie · March 2014

Mommyathome, all the women who've posted in this thread before you have had lumpectomies.

Mommyathome · March 2014

Thanks Beesie. Just want to make sure I'm doing all I can to not have a reoccurrence.

percy4 · March 2014

Hi Mayanne - I had a BIG upset about doing rads at all, was (am) unhappy about the possible side effects, etc. Decided to proceed as I really had no choice. I had clean but narrow margins, and it just wouldn't have been logical to not do rads. Then, like you, I had to decide if boosts to the tumour bed were warrented. I wanted as little "poison" as possible. However, in really thinking about it, I had to conclude that it would be foolish to go through radiation, something that can only be done once in a lifetime to the same breast, and not get all I could out of it. So I'm just finishing the boosts Monday, and I think I'd feel like I'd left something out that could have helped me if I hadn't done them. And though I was REALLY skeptical, I'm happy I've done the boosts. I would feel very upset if I had a recurrence near the tumour bed later, and I had not done the boosts. I certainly agree with you that you should have been told that the end treatments were boosts, and what they were, instead of having to find that out on your own. - P.

Mayanne · March 2014

Thanks, Percy, and everyone else here. Yes, I guess we go through our lives trying to avoid as much radiation as possible and now we have it every day for more than six weeks - it's bound to disturb and cause us to question. But that's a good thing, too, because to dive in without studying the pro's and con's of something so important might make us second guess ourselves later on. This way we'll know that we learned all we could from reading and learning from wonderful people here.

What helped me to decide on the boosts was reading redsox's explanation and also putting my trust in my RO. And, like you, since I've gone this far, I might as well finish the whole prescription that was planned so carefully by the team (RO and Dosimetrist). If I refused and had a recurrence, I think I'd always have wondered if it was because I hadn't followed through with what years of experience had taught the experts.

Boosts or no boosts

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