Trying to decide if I should do Radiation

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Denisenim
Denisenim Member Posts: 7
edited May 2015 in Radiation Therapy - Before, During, and After

Two weeks ago I had a BM with bilateral sentinel node removal. Prior to surgery my right sentinel node was positive for IDC. I had 6 rounds of neoadjuvant chemo including targeted therapy of Herceptin and perjeta prior to surgery. Pathology confirmed no evidence of cancer in any of my breast tissue or in my lymph nodes after surgery (yay!!!!). I am seeing the radiation oncologist again on Friday and know he is going to going to recommend radiation. I am nervous because I don't want it to mess up my tissue for reconstruction. I am wondering if anyone here has the same type of cancer who has or hasn't had radiation and what they have experienced. Of course I am worried about reoccurrence but wondering if the risks of radiation don't outweigh the benefits

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  • Rose0766
    Rose0766 Member Posts: 92
    edited April 2015

    hi denisenim, I too am having a difficult time deciding about radiation, I had mastectomy with tissue expander, preop measurement on mri of tumor was approx 4 cm, pet scan showed two nodes, possibly three, my RO is of the belief you treat the prechemo diagnosis, I also had PCR. I've read every stat I could find , as many studies as I could find, RO said I have a 30% chance of recurrence, I'm seeing MO on Tuesday and I'm going to ask him what he sees as my recurrence risk. I remember him sayings one time a of it was approx 10%. RO says I need 33 tx to chest wall, axillary nodes and suprclavicular nodes. I had an ALND, all the articles I've read say dont do the axillary with an ALND. Besides continuing herceptin for the year I'll be on tamoxifen. I understand my cancer is aggressive, but postop path report says no cancer. Right now I'm 90% sure I'm not doing RADS. Quality of life has to count for some part in this

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  • Denisenim
    Denisenim Member Posts: 7
    edited April 2015

    It is very difficult to decide. My RO said that he didn't know my chance of reoccurrence because there are not a lot of studies out there right now for people who had neoadjuvent chemo with Herceptin and perjeta. He told me RADS would lower my reoccurrence rate by 20-25% but 20-25% of what reoccurrence percentage is my question. He said it would also increase my overall survival rate by 10%. I iinitally had a 4cm tumor in my lymph nodes and he said it looked like 3-5 were involved. I had 5 removed that all tested no evidence of cancer along with my breast tissue.  I am disappointed in my oncologist because she has not given me many statistics to look at. I am really on the fence here and don't know what to do!!!  ARRRRGGGHHHH!

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  • SugarCakes
    SugarCakes Member Posts: 353
    edited May 2015

    I'm facing the same and there seems to still be no answers or guidance, even :(

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  • Italychick
    Italychick Member Posts: 2,343
    edited May 2015

    I hate the number game. What I want is somebody to sit down and say ok, surgery only, 70% no recurrence. So, then let's deal with the 30% remaining risk. let's say chemo reduces it by say, 10%. So now I am 80% chance of no recurrence. So radiation removing 20-25% risk, is that 20% of the remaining 20%, which I think means a 4% reduction? I don't like the numbers doctors throw out. I want real numbers. I still don't even understand how much doing chemo reduces the risk.

    It would be nice if we could just get straight answers. I'm not even sure at this point if I'm going to just stick with the lumpectomy or go further and get the mastectomy because of negative receptors and no long term hormonals. Next time I meet with a doctor, I'm going to take a piece of paper and make them write down percentages, because if I add up all the numbers I have been told,it is greater than 100%.

    And where do negative/positive nodes factor in?

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  • avmom
    avmom Member Posts: 324
    edited May 2015

    Initially after my mx, my MO said that he didn't think that radiation therapy would be recommended in my case (see my profile for stats). He said he would review it with his colleagues, and he also had the pathology reviewed. Mon review, the grade of my tumour was upped from grade 1 to grade 3. When I met him last, he still didn't think radiation would be recommended, but did say that it would be worth having a radiation consultation to review the risks an d benefits, so I've been trying to read up on it.

    The most recent thing I've seen is an abstract in the Journal of Surgical Research, published online on April 7, 2015. The researchers did a retrospective cohort study of 2874 women with T3 node negative Breast cancer from the 1998-2009 Surveillance, Epidemiology and End Results Database, looking primarily at survival rates. The study concluded that post mastectomy radiation therapy is not clinically beneficial in T3 node negative Breast cancer. I think you can access the abstract at http://dx.dol.org/10.1016/j.jss.2015.04.012

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