My doctor changed is mind about radiation

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jd44
jd44 Member Posts: 3
edited February 2015 in Radiation Therapy - Before, During, and After

Dear,


I'm writing you about my wife.

She lost her mother from a ovarian cancer at 37, and her grand mother died from breast cancer.

At the age of 35 (now), she went through BRCA1 genetic test.

We get the resultat last month, unfortunatly the was positive to BRCA1 mutation.

So she get scanner, mammography and which show a small tumor triple-negative of ~8mm.

So after long discuss with the doctor have been decided to do a double masectomy, immediate reconstruction by protese (if lymph node are negative). and then chemotherapy.


All the time doctor, told us, that if LN- she will not need radiation.

But yesterday, 2 weeks after surgery, doctor announce to her that she will need radiation?

You can imagine how we was.

But the point is why?

At the end the tumor analysed resultat was:

  • The cancer is 1 centimeters or larger
  • The cancer had not invaded the lymph channels and blood vessels in the breast.
  • The removed tissue has a NO positive margin of resection.
  • NO lymph nodes were involved.
  • The cancer has NO invaded the skin


Do you have an explanation? Idea?



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  • bride
    bride Member Posts: 382
    edited February 2015

    Hello,

    I think your docs are being cautious and thorough. Did your wife's post-surgery pathology report say any thing like "there is no evidence of disease" or something like "no cancerous cells were found"? If not, I think your docs want to use radiation to destroy any cancer cells which may be present. Since your wife is triple negative, there are fewer meds available to wipe out any remaining cancer cells. Radiation is generally far less grueling than chemo.

    Please note that all I can do is guess. You need to ask you wife's doctors why they added radiation.

    Wishing you and you wife the best,

    bride

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  • Traveltext
    Traveltext Member Posts: 2,089
    edited February 2015

    Radiation is a form of BC insurance. It is the less stressful of all the treatments and quite pain-free, so why not go ahead with it?

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  • Bounce
    Bounce Member Posts: 574
    edited February 2015

    Dear Traveltext

    Radiation is not pain free for everyone and can cause long-term problems. There are a lot of reasons not to do radiation. There are also a lot of reasons to do radiation. It isn't simple.

    However - each person has to weigh up the pros and cons for their specific situation.

    I think jd44 should ask his wife's doctor why he considers it necessary.

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  • jd44
    jd44 Member Posts: 3
    edited February 2015

    Thanks to everyone.


    We understand a radiation is one more security/security. The fact is doctor told us she will not need radiation, and 15 days after radiation doc' change their mind with no new information.

    More precisely oncologist still thinking she don't need and doesn't understand radiotherapist recommandation. And is the radiotherapist who haven't been consult before surgery who decided/recommand she will need it, after surgery.


    We understand the pro/cons of radiotherapy, but keep in mind she get breast reconstruction, so she will probably will be needed new sugery after radio.


    And if we read : http://www.breastcancer.org/treatment/radiation/wh...

    in case of mastectomy .. Radiation may be recommended if any of these factors are present:

    • The cancer is 5 centimeters or larger (the cancer can be 1 lump, a series of lumps, or even microscopic lumps that together are 5 centimeters or larger).
    • The cancer had invaded the lymph channels and blood vessels in the breast.
    • The removed tissue has a positive margin of resection.
    • One or more lymph nodes were involved.
    • The cancer has invaded the skin (with locally advanced or inflammatory breast cancer).

    But none of them are present.

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  • doxie
    doxie Member Posts: 1,455
    edited February 2015

    I'd suggest getting a second opinion from another RO. It does seem an unusual suggestion to do radiation under the circumstances described, with the BMX, smaller size and no lymph node involvement. Radiation may cause problems for breast reconstruction, so getting it for a very small % of benefit may not equal the risk involved, and it is not risk or pain free.

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  • bride
    bride Member Posts: 382
    edited February 2015

    I imagine that your RO is waiting for the surgery pathology -- from your posts I'm a bit confused as to whether your wife has had surgery. When you use the term radiotherapist are you referring to a Radiation Oncologist? If so, I'd try to understand why the RO and the MO don't agree.

    It might make things clearer if you felt comfortable telling us what type of cancer your wife has, what her stage is, and what treatments she has had. That your wife is having reconstruction is not as important as making sure she has no evidence of disease.

    I understand that you know the risks and benefits of radiation. I hope you are equally familiar with the risks and benefits of reconstruction.

    And remember that you have the right to get a second opinion about what both your RO and MO are telling you

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  • jd44
    jd44 Member Posts: 3
    edited February 2015

    Thanks for everything.

    Sorry if everything aren so clear, as english aren't my language as you could guess.


    So My wife get his surgery 15 days ago for her triple negative tumors breast cancer, and we already get surgery pathology.

    Cancer tumor have been confirmed.

    • the tumor is 1cm / invasive ductal adenocarcinoma grade III (3,3,3),
    • ER-, PR-, HER2-
    • Negative vascular embolle
    • Ki-67 80%
    • Lymph node negativ


    At the moment she didn't start yet chemoterapy, but she will get through 3-EC / 3-Taxotere



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  • bride
    bride Member Posts: 382
    edited February 2015

    JD,

    Please don't worry about your English, you're perfectly understandable. I know very little about IDC but there is forum here for it. You will probably get better information there.

    Although your wife's tumor is small, the pathology report suggests that it is more aggressive than average. Between your wife's triple negative status and the nature of her tumor, it sounds like her doctors are cautious and are wanting to make sure they eliminate all cancer. That may be the reason that they added on the radiation.

    I know things are very confusing and scary right now. Try not to panic -- IDC makes up 80% of breast cancers. You might want to call the American Cancer Society (if you are in the US) at 1-800-227-2345 and ask if they can provide you with a cancer navigator. The center that is treating your wife will have social workers who can help you with dealing with the doctors. The social workers can also help you find a second opinion.

    For now you might want to use the left handed side menu to go to the IDC forum -- I'm sorry but I don't know how to link you there.

    Take care,

    bride

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