Bilateral mastectomy - do i still need radiation?

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tsoebbin
tsoebbin Member Posts: 474
edited May 2016 in IDC (Invasive Ductal Carcinoma)

I just got the pathology back from my lumpectomy. My original DCIS dx has turned into 2 spots of invasive cancer. One spot is 11mm and the other is 4.5mm and they were not next to each other. Every slide had DCIS on it.

It is being tested for HER2 status right now and i hope to know more about that today.

Bilateral mastectomy is in my near future.

Now I wonder... if I have to have both breasts removed... do I have to have radiation? I forgot to ask the surgeon about that today when she called. I think my brain went haywire for a few minutes!

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  • ksusan
    ksusan Member Posts: 4,505
    edited May 2016

    Yes, a bilateral often doesn't mean radiation won't be recommended when there's an invasive cancer.

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  • tsoebbin
    tsoebbin Member Posts: 474
    edited May 2016

    here is a dumb question... what do they radiate if the breasts are gone? Sorry... trying to wrap my head around all of this new info.

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  • HuskerFan
    HuskerFan Member Posts: 85
    edited May 2016

    That's interesting......I have 8mm IDC and have been told I won't need radiation after my BMX. I'm curious to know the criteria they use to decide.

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  • tsoebbin
    tsoebbin Member Posts: 474
    edited May 2016

    I do not know my HER2 results yet, I wonder if that is a factor?

    So many fine details!


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  • grammakathy
    grammakathy Member Posts: 407
    edited May 2016

    it will depend on whether they can get clear margins in the surgery. Hopefully, yours will be clear. I have a friend who needed both radiation and chemo following her Mx. She needed radiation on her chest wall. Keeping my fingers crossed for you.

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  • ksusan
    ksusan Member Posts: 4,505
    edited May 2016

    They radiate your chest.

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  • Ridley
    Ridley Member Posts: 634
    edited May 2016

    I believe the decision will depend on margins, how close the tumours are to the chest wall and whether any nodes are positive. I don't think hormone status or HER2 impact the decision. I had a lumpectomy first, then bilat mastectomies -- and no radiation.

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  • Smurfette26
    Smurfette26 Member Posts: 730
    edited May 2016

    My cancer was multi focal ILC with one node involved. My surgeon got really good margins and rads were not recommended for me. Thinking of you and wishing you well on your journey. Donna.

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  • tsoebbin
    tsoebbin Member Posts: 474
    edited May 2016

    So much to learn isn't there? Just when I think I know what is going on.. it changes!

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  • Hopeful82014
    Hopeful82014 Member Posts: 3,480
    edited May 2016

    tsoebbin - "So much to learn isn't there? Just when I think I know what is going on.. it changes!"

    That's pretty much it in a nutshell!

    After a while, one learns not to put to much weight on any expectations or get too invested in a particular outcome. ;)

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  • SthrnYankee
    SthrnYankee Member Posts: 25
    edited May 2016

    I was recently diagnosed with Invasive Ductal Carcinoma & will be facing a bilateral Mastectomy with reconstruction soon. This is all so new to me & I am waiting on ER receptor & Her2 tests to come back also. The radiation Oncologist i saw told me that at this point for me she does not feel like I will need radiation, but that depends on those tests.

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  • AmyQ
    AmyQ Member Posts: 2,182
    edited May 2016

    Even if radiation is recommended, you do not need to have it. I was told I needed rads but refused and I'm very happy I did. My friend is 3 years post radiation to her chest and has been battling radiation pneumonitis in both lungs. A little known side-effect which she most likely will have the rest of her life. She regrets her decision. Again, a very small percentage of people suffer this SE but it's a risk. I wasn't willing to risk it.

    Good luck with your decision.

    Amy

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  • hyphencollins
    hyphencollins Member Posts: 109
    edited May 2016

    I had radiation after mastectomy due to positive margin. I think that is not common, but not entirely unusual either. Fortunately, the radiation was straightforward and I had limited, and minor, side effects. My reconstruction turned out ok (not beautiful but it actually looks worse on the nonradiated prophylactic side!) even with rads.

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  • Paxton29
    Paxton29 Member Posts: 221
    edited May 2016

    I had a BMX and I needed radiation because the margin was close on one side and dirty on the other. But I am somewhat unusual because my cancer was bilateral. I am node negative but the margins is what bought the rads for me. I am thin and didn't have much tissue to spare in the first place, which I think played a role.

    The thing is, we're all so individual; they consider so many things. Generally, I think it's rare to need radiation after BMX, because they can get good margins, so hopefully that's how it works out for you!

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  • Jenwith4kids
    Jenwith4kids Member Posts: 635
    edited May 2016

    I think node status is an indicator. I had a BMX and an ALND, 4 or 5 positive nodes (I can't remember). I had radiation. It kinda cleans up any stray cancer cells after surgery and chemo.

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  • Dawn41
    Dawn41 Member Posts: 54
    edited May 2016

    My breast surgeon said they typically don't do radiation on tumors smaller than 5cm, but it all depends on the final pathology after the masectomy. I asked because I was originally going to need radiation after the lumpectomy but things changed after pathology came back on that and now scheduled for a bilateral mastectomy with immediate DIEP flap reconstruction June 22.

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  • tsoebbin
    tsoebbin Member Posts: 474
    edited May 2016

    You are all so very helpful. This is day one for me and I am just trying to wrap my head around this and manage my expectations! Many thanks to all!

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  • dtad
    dtad Member Posts: 2,323
    edited May 2016

    In general radiation is not needed if you have a BMX. Of course there are situations where it is needed. Tumor close to chest wall and multiple node involvement are a few. My surgeon told me I would definiltey NOT need radiation if I had a BMX, and it was one of the factors that helped me make my decision. Good luck to all....

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  • ksusan
    ksusan Member Posts: 4,505
    edited May 2016

    I had one positive sentinel node and wide margins; the recommendation from multiple docs included radiation.

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  • placid44
    placid44 Member Posts: 497
    edited May 2016

    I had radiation after BMX in part because I didn't have an axillary dissection. I had the breast andnodes radiated. I had one positive node.

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  • Artista928
    Artista928 Member Posts: 2,753
    edited May 2016

    I had clear margins. For me it was tumour size and micromets to SN. BMX doesn't mean they got it all, even with clear margins. There could be stragglies hanging out in the skin.

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