Is radiation required for a complete pathological response?
Comments
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I tried to find similar cases and I didn't so I'm hoping to get some help with this post. I had neoadjuvant chemo for IDC with axillary node involvement. I responded very well to the treatment as both the lump in my breast and the lymph node disappeared. Then I had mastectomy with ALND and the results indicated a complete pathological response (no sign of tumor in breast or any of the 10 lymph nodes removed). Now MO says I should have 5 weeks of rads while both surgeons think there is no need for rads. The PS is concerned about the risk of capsular contracture (I had immediate reconstruction). So am I but I would like to know I did everything to minimize the risk of recurrence. I'm scared of any more surgeries or the higher risk of lymphedema but I don't want to go through this all over again! Any thoughts
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Have you consulted with a RO yet? That was my first step before any decisions were made about rads
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I had a complete response to chemo as well !! I agreed to go talk to the RO thinking I wasn't going to do radiation but after him explaining why it was recommended I decided to go ahead !!! Maybe he/she will tell you different and put your mind at ease. Get all your options and make a decision based on that info
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Yes, speak with RO about this. Good luck
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I agree with everyone. Each person is unique and so is their treatment. I would ask for a consult and be armed with a list of questions and concerns. In my case because I'm triple negative my team wanted to throw everything at it. I also had PCR with no node involvement but it was still recommended to do full rads to supraclavicular, whole breast and axilla. I have a background of dental radiation and understood the amount of radiation I would be getting. This really didn't sit well with me BUT in the end I couldn't forgive myself if I didn't do everything I could to give myself the best chance. I did do the recommended course and I'm very grateful to be NED. My cancer was very aggressive (3.3 cm in 8 months) but I'm more aggressive
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I just faced this discussion yesterday. I had 3/9 nodes that previously had been involved (confirmed with axillary dissection during lumpectomy) and had complete response on those and the breast tumor. The RO is doing whole breast radiation over 4 weeks of hypo fractionated treatment. He does not recommend doing my axilla or the other nodal areas. I am at Dana Farber.
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I consulted 2 RO's and both said that radiation would only reduce my risk of local recurrence by about 5% and it would do nothing to reduce my risk of metastatic disease. They would only radiate the left chest wall - which increased my risk for damage to my heart and/or lung. They also said they would not radiate the axilla where my positive lymph nodes were so I opted not to do rads…as others have recommended, consulting with an RO helped me understand the risks and benefit, good luck with your decision.
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Thank you all for you responses. It means a lot. I'm still waiting for an appointment with the RO and I will definitely ask him a lot of questions! As slv58 said, I want to do everything I can to give myself the best chance. I am only 35 and I plan to have a family (with babies; ok, at least one baby) and a normal life. I hope to be lucky and have no serious side effects from rads, in case I will have them I will let you know after my meeting with the RO. Best wishes to all of you!
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I also had a complete pathological response, but the RO recommended I have radiation due to my tumor size initially and my age. I had the same type of cancer as you Stage IIB, one lymph node was involved.
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Thank you, Libby. After my meeting with the RO, I decided to go ahead with the 5 week treatment. I already started, today was the forth session. Everything looks good so far and I keep my fingers crossed for the next sessions.
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Now that you're a month into radiation, I'd be interested to hear how it's going for you, cldnkl.
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Hopeful82014, I'm doing great! I just finished the 5 week radio treatment and I can say it wasn't as bad as I expected
. On the third week my skin became a little red and by the end of the treatment it was more sensitive, a bit itchy and it looked as if I was tanned. For the first three weeks I used Aloe Vera gel and after that, Derma Gran-B cream (dressing). The implant doesn't seem affected and the scar looks much better (one other benefit of radiation). I hope this helps and if you have any questions, l am here. Best wishes!
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Congratulations on finishing up! I hope you can take some time to catch up with yourself and all the other aspects of your life that had to get by with a lick and a promise since your dx - including recreation and time for yourself.
I'm very happy to hear you did so well during radiation and that it had some visible improvements for you, too, as far as the scar. The Derma Gran-B cream is one I'd not heard of, so will add that to my little notebook of tips - thank you.
Thanks most of all for sharing your experience and insights, and making yourself available. I truly appreciate that. Here's hoping the itching and sensitivity passes off a.s.p. Best to you, also.
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