I hate being such a difficult case! Radiation help!

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Miscraw
Miscraw Member Posts: 45
edited October 2014 in DCIS (Ductal Carcinoma In Situ)

I had a BMX with immediate reconstruction on August 1st for a large area of microinvasive DCIS, grade 3. I am also slightly ER positive & HER2 positive. I am also only 39 years old.  At first, my MO suggested Tamoxifen only. Then after presenting my information to other doctors, she suggested Taxol and Herceptin a couple weeks later. I was very upset & even got a 2nd opinion, who also suggested the chemo. They really wanted me to have Herceptin! So, last week I very very very reluctantly started treatment.

Then out of the blue they wanted me to see the Radiation Oncologist. I had close margins & the MO just wanted to run things past him to rule out radiation. Unfortunately, he suggested I do radiation.  Well, here I am 8 weeks out from BMX & all of the sudden faced with rads. I have been getting tissue expansion this entire time & am pretty much done. I only had to wait for chemo to get my implants. I met with my plastic surgeon Friday, who is also very disappointed that this was ruled out weeks ago & is now back on the table. She brought it up again at her tumor board last week & they all ruled it out. This included a RO. I just don't know what to do. Plastic surgeon said our work will basically go out the window with radiation. She isn't trying to talk me out of doing it but just said reconstruction will be very difficult & compromised with radiated tissue. I do not qualify for another type of reconstruction, other than implants due to being thin.

It just seems that my case is very difficult & I feel like I'm being overtreated. Although I don't want undertreatment either. I just went from surgery only to all possible therapy. It's very frustrating & I don't know what to do about radiation!

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  • inks
    inks Member Posts: 746
    edited October 2014

    I did not have DCIS but I did chemo and had to do radiation too because of my age (36) and LVI. I am having an exchange to permanent implants in 2 weeks. I personally know of 2 women who had success with implant reconstruction after radiation, so it is possible. I think the main reason they recommend radiation is the close margins and your age. If you end up having a local recurrence the outlook is not great. Radiation will reduce the chance of local recurrence. I did extensive research on radiation after mastectomy before I agreed to it. You need to see the numbers yourself to understand why they are recommending radiation. Good luck with your decision.

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  • BayouBabe
    BayouBabe Member Posts: 2,221
    edited October 2014

    If you do end up doing radiation, please do some research on fat grafting.  I have had implants after radiation.  Fat grafting has done wonders to heal and restore my skin and tissues on the radiated side.  Good luck with your decisions.  

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  • alizbeth
    alizbeth Member Posts: 29
    edited October 2014

    I was a difficult case as well.  I had a mastectomy for extensive, multi-focal DCIS in June of this year (age 42 at diagnosis).  Following the mastectomy, I had very close margins (0.1 cm).  My MO presented my case before the tumor board; I think b/c he thought they would recommend radiation.  However, the RO sided with the breast surgeon & reconstructive surgeon, and she did not recommend radiation.  I met with the RO separately just to be sure. 

    In my case, they removed the fascia, which is I think something akin to the connective tissue below the breast tissue.  In the breast surgeon & RO mind, this would have gone beyond the margins.  So, you may want to ask your breast surgeon if he / she removed the fascia.  That could make a difference.

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  • clarrn
    clarrn Member Posts: 557
    edited October 2014

    I am doing rads after BMX and chemo due to lymph node involvement.  I have a tissue expander in.  It is very individual so I agree with whoever said to look at your numbers.  My PS said we would not have problems with the exchange to implant as long as we wait 6-12 months post rads to do the surgery.  Your PS will put cosmetics above recurrence/survival and your RO will have the priorities opposite.  You have to decide if the risk of recurrence is acceptable without rads, a numbers game with no guarantees unfortunately.  Good luck with your decision,  how I wish we had a crystal ball :)

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