Radiotherapy after more than a year of Chemo and Biologics

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Sam0408
Sam0408 Member Posts: 4
edited July 2016 in High Risk of Recurrence or Second Breast Cancer

Hi, I am 47 years old and was diagnosed with breast cancer in March 2015. I had G3, ER/PR- and HER2+ breast cancer. Underwent mastectomy in March 2015 and had one lymph node removed which had one micro-metastasis and lymphangiosis carcinomatosa, followed by chemotherapy and started my HER2 inhibitors in Jul 2015. I just completed my HER2 inhibitors treatment in Jul 2016. I am at the moment considering the need of radiotherapy. I am aware that radiotherapy would usually follow after chemotherapy and since my chemotherapy ended in Oct 2015, would it be too late for radiotherapy? What are the benefits after more than a year of chemo and HER2 inhibitors? Would it still be worthwhile to do radiotherapy at this point?

Any thoughts?

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  • muska
    muska Member Posts: 1,195
    edited July 2016

    Hi Sam,

    First of all, congratulations on completing such a long and difficult treatment!

    I am not a medical professional and I don't know what the NCCN Guidelines say with regards to only one positive node - you can probably research it if you want - but I think asking your medical team is quite reasonable. They may not recommend radiation if only one node is involved and you had a strong systemic treatment anyway. You mentioned you were on HER2 inhibitors, did you mean Herceptin?

    Generally speaking, they recommend radiation be started within 8-9 weeks after the completion of chemo. Research has shown if started after 9 weeks radiation effectiveness on reducing local recurrence starts to decline.

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  • Sam0408
    Sam0408 Member Posts: 4
    edited July 2016

    Dear Muska,

    Thank you for the reply and the information. It is not an easy decision and thus am looking for more information if it is worthwhile to start radiotherapy after more than 9 week after chemo.

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  • BarredOwl
    BarredOwl Member Posts: 2,433
    edited July 2016

    Hi Sam0408:

    Have you received a recommendation from a Radiation Oncologist for post-mastectomy radiation?

    If so, please contact them first thing Monday, without further delay, to ask for expert advice on your question and next steps.

    If not, please request a referral to a Radiation Oncologist and urgent appointment noting date of surgery, what adjuvant treatments were completed and when, and obtain case-specific advice about post-mastectomy radiation, preferred timing relative to other treatments, and possible impact on benefit (if any) of same.

    Best,

    BarredOwl


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  • Sam0408
    Sam0408 Member Posts: 4
    edited July 2016

    Thank you BarredOwl. Have set up appointments already with the Radiation Oncologist and will seek their expert advice

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