Radiation After Mastectomy AND LESS THAN 4 LYMPH NODES INVOLVED
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brandi999, I go to see my MO on April 7 for next herceptin, I'm taking my studies with me and asking him what he thinks, when I saw him last time, I told him concerns regarding need for RADS based on my stage and me getting PCR, he kind of warned me RO would say I need treatment, but in the same breath said he was calling in script for tamoxifen so I could start it once I decided. MO said I had a 10 % chance of reoccurrence, RO said 30% WTF?
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Rose0766, the RO told me that my percentage of local recurrence was very low due to the great surgery that I had.. larger than required clear margins. Small cancer and only 1 out of 17 nodes positive. The radiation would only knock it down by a few percentage points. She knew I was hesitant but never once did she tell me I definitely needed to have radiation. Both my MO and RO said the biggest bang for my buck was the hormonal meds..which i started 3 weeks after finishing chemo.
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thinking positive, I'm assuming your chemo was after your surgery? I had chemo prior to and it killed everything. I understand that there is still a chance there is still microscopic floaters but if chemo killed main Cancer, it would stand to reason that the micro cells are dead too. Plus I'm doing tamoxifen and herceptin. My cancer was grade 3 as well. I'm glad to see I'm not the only one that doesn't see the need for radiation. I've been researching this since I found out rads was a possibility, but after I had Pcr with chemo, I thought what are we radiating?
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Yes because chemo is the general one that goes after all the cells in your body. Radiation is targeted to a specific area so if there isn't any there, what's the point? They will be radiating my stomach fat.
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I had one node positive. I had neoadjuvant chemo, bilateral mastectomy, andradiation. BS and onc recommended radiation because I did not have an axillary dissection and because I am triple negative.
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"What did I decide to do after starting this post????"
For anyone who might be curious.....I've made my decision based upon a second opinion from a Radiation Oncologist who has recently completed studies on this matter.....granted, his studies were conducted among patients who had lumpectomies NOT bilateral mastectomy, as I've had. Nonetheless, his information was current and very helpful to me.
In a nutshell, I WILL BE HAVING radiation because according to him, I am at risk of recurrence, due to a number of my own individual breast cancer details. I am under age 50,IDC, HER2+, LVI present, lymph node (axilla) effected, macro (as opposed to micro) invaded, blah, blah, blah!!!!! The list sounded crappy and I sunk in my chair as he spoke. It was a second opinion and nothing at all like the first one - where the Radiation Oncologist told me that he was completely "on the fence" about whether I needed radiation or not. This second doctor, however, reminded me of my original goal....and the reason that I opted for a bilateral (as opposed to partial) mastectomy...."risk of recurrence".
At the end of the day, I am TERRIFIED of getting this cancer back and have decided to HIT IT HARD, WITH EVERYTHING I HAVE, THE FIRST TIME AROUND and hope for ZERO RECURRENCE in my lifetime. So, that is what I am going to do. If any of you wish to discuss this personally, please feel free to private message me. For obvious reasons, I don't think my choice should be discussed or debated as an ongoing thread (each choice is very personal and I don't want to confuse or hurt anyone with mine)....but since I started this post, I thought perhaps some of you might want to know what I decided and why? Then, you can add it to your own arsenal of information and considerations...and hopefully, use it to your own advantage, based upon your own scenario.
For me, this all comes down to recurrence/aka my personal nightmare...I never, never, never want to have to endure any of this again and radiation helps to reduce this risk....soooooo, yucky as it sounds....I will do this thing 25 times and be tough about it if I can! I think I just got excited to end chemo and really hoped that I was "all done"....but this journey of mine will continue for a while yet....and Herceptin until April 2016!!! ):
I am bald, boobless, port lump sticking out of my chest, tired and almost always a little afraid. Buuuuut, I got this!!!! I'm trying to be brave about all of it, but it definitely sucks! I am meeting with my radiation team TODAY for my radiation treatment planning appointment and told that I should be starting rads May 25th.
My best wishes to the rest of you ladies as you go through your own ups and downs. Please contact me anytime you need support....not sure that i can solve anything but always willing to listen and I do care, very much.
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Good luck - I would have done the same. Sure hope they were right for me.
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Hello Again Ladies!! Me again....the one who started this post!!!!
Sooooo....another update for you....I finished radiation (25 treatments) on July 3rd!!! I've been home watching and waiting for something horrible to happen to my skin and....whew....nothing has happened yet and it's been 18 days!!! So how was my experience? Awesome, all things considered!! The team was terrific. The daily visits SUCKED because I can think of a million other things that I would have rather done each day!!! lol However, I tried to make it an adventure!! My kids had to come with us each day (hubby drove the van!!) and we did fun, day excursions as we could. Visit the mall. Go for lunch or have a picnic. Sit in the shade at the beach. Whatever we could to make the trip feel like it had a happy purpose - not just hospital and rads!!!! And it worked for me!!! I have some slight tan marks where they radiated, but I don't think they will stay forever and even if they do...they are very slight. All things considered. I RANG THAT BELL (again - already completed 8 chemotherapy sessions) and SKIPPED OUT OF THAT HOSPITAL. And now? Now I am supposed to live!!! I am supposed to carry on and hope that I took every precaution necessary to stop bc from recurring in my body. Somedays this is easy to do and some days I feel nervous or anxious....but I suppose that is another post altogether, right? For me, radiation is behind me and I have no regrets. Good luck ladies!!! This journey is not easy but at least we are not alone.
As always, feel free to contact me anytime by personal message. I will always answer.
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Nice to see you again PerAngusta. Congrats on finishing active treatment. Are you doing endocrine therapy, too, or are you completely finished? Either way, good for you!!
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Thanks Hopeful!! Not entirely finished...still have the port in my chest and tri-weekly Herceptin infusions for HER2+ status AND daily oral dose of Tamoxifen to block the estrogen. But my docs want me to proceed as though cancer is gone. So, I'm going to try. But I'm fairly sure that I will be visiting a forum on how to cope with the end of cancer treatments and moving on with the fear of recurrence. lol So, if anyone is looking for me....check posts related to this topic and chances are...you'll find me there!!
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That's good to know. Best wishes for the next phases, PerAngusta.
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Hot off the press....my second opinion doc (Dr. T. Whelan) just had his radiation findings published in the New England Journal of Medicine July 23, 2015. Conclusion - Among women with node-positive or high-risk node-negative breast cancer, the addition of regional nodal irradiation to whole-breast irradiation did not improve overall survival but reduced the rate of breast-cancer recurrence. (Funded by the Canadian Cancer Society Research Institute and others; MA.20 ClinicalTrials.gov number,NCT00005957.)
Hope this helps someone else!!
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PA - I just read that study yesterday! I thought the headline was somewhat misleading (at least the version I saw) but the overall findings that RT reduced recurrence - and, I believe, distant recurrence were very encouraging. Particularly so for me, as I am in that high risk, node positive group and in the middle of radiation and struggle daily with the risk/benefit equation.
It's great that you had access to someone of that caliber for a 2nd opinion. Thanks for sharing that info with all of us. -
bump because I'm also in a gray area, though all of my nodes were negative. . . .
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To everybody who is in a gray area I would recommend getting 2nd and 3rd opinion from radiation onologists. There are too many individual factors to take into consideration. For example, someone who is young and healthy and has potentially many years of life ahead might chose a more agressive approach even if that reduces risk by a few percentage points only vs an older woman with existing health issues. Those few percentage points may translate into quite a risk reduction over that younger woman's lifetime. Just thinking aloud...
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