anyone out there who opted out of radiation?

One problem with that approach is that you don't know for sure that any recurrence would be confined to a local or regional recurrence. There's no guarantee of that, unfortunately. It could be a distant recurrence; is that something you have considered?

Yes, radiation can cause issues, including 2ndary cancers. I'm not downplaying the risks but the odds of a radiation induced cancer are pretty small. With any degree of nodal involvement, no matter how small, it seems risky to avoid radiation. Almost all of the statistics establishing the safety of lumpectomy include RT as part of the treatment.

FWIW - I wasn't happy about the need to do RT and would have skipped it if I could have but I realized that would have been playing with fire.

There's no doubt that opting for RT is intimidating. I get that. Good luck with your decision making and treatment.

wow! I've ever heard of being paralyzed either- so sorry that happened to you.

I talked to my radiation onco, and she put a lot of my fears at ease. I think I'm going to go through with it :-)

Icandoallth....Kind of you to reply, and thank you for your sympathy. Yes, it's a problem. I am told to keep my condition under surveillance and yet I cannot have MRIs. I believe it is the dye that screws me up - who knows?

Good luck with your decision.

I met a woman the other day who had Triple -ve BC. She had all the treatment and has been left with a 20% chance of it recurring.

I have had surgery only - however I am taking hormonal treatment for some years (my BC is hormone receptive) - and I have been told I don't need chemo - it would only have a 3% benefit for me, so I said no to that! Yippee! However I have been told that I have a 20% chance of recurrence - like the other woman who cannot have any further treatment - if I don't have rads. The chance of recurrence would be reduced to 7% if I had Rads. But what of the side effects???????? Who knows.

I think surgeons are wary of it and oncos think it's brilliant. I have no idea what to do.

BTW the Triple -ve woman had very little, if any, side effects from the rads - she took a shea butter cream in and put it on IMMEDIATELY she came out of the machine and she's fine. She too is slim, but she is only one person.

BW

There is a school of thought that those who cancers have "favorable biology" may be able to forego radiation.

There is a clinical trial, IDEA Study (Individualized Decisions for Endocrine Therapy Alone), that is just starting. It is being initiated by the University of Michigan with multiple centers across the nation participating. It is for post-menopausal women aged 50-69 with a single invasive cancer that has what doctors call "favorable biology" - lumpectomy with Oncotype DX score less than 18, PR/ER+, HER-, clear margins of 2mm, no lymph node involvement and on hormone or endocrine therapy.

Considering it - waiting for Onco score, but nervous.

I resisted. Told the doc I really really did not want to be fried up like a piece of bacon. She laughed that I had made it through 2 surgeries and chemo but was afraid of radiation.....then rattled off some statistics and said my chances of recurrence would drop. I bought it. 

Now, 90 days after, I am developing this AWFUl fibrosis. It's the very first thing I feel when I wake in the morning..... And I have regret. It's my right arm and I'm right handed. It's affecting everything I do. It won't let me forget that my life will never be the same

May I asked for advice about need for radiotherapy. My partner has breast cancer. About 2 years ago she has a small cancerous lump removed. Right breast. She has implants and at same time had lumpectomy with nipple removal and reconstruction (new implants both breasts). She opted for zero treatment after Surgery. Another small lump reoccurred few months ago. Cancerous. She had it removed. On both occasions her lymph modes were negative. She is grade 2. She 35yrs old. Yesterday had her 3rd chemo treatment. One more to go. Yesterday she saw her 2 doctors. The one that did the surgery and the oncologist. Both told her she needs to have the radio treatment after the last chemo. Mentioned if do not then 30% chance reoccurrence. She wants to not have radiotherapy. We live in Thailand and she it at a very good hospital she with good doctors. Treatment is expensive 25 treatments at about $350us a treatment. However cannot put price on health. Any advice would be greatly appreciated. Thank you.

"I have been told I have a 20% chance of the c coming back if I do not have radiotherapy, i.e. an 80% chance of it NOT coming back if I don't have rads.“

A woman has only a 1 in 8 (12%) chance of developing breast cancer by age 80. Yet here we all are. 20% chance of recurrence is an unacceptable level of risk for me if there’s anything I can do about it.

My onc told me only one in five people get 100% response to chemotherapy. It is a mystery why chemo works on some folks and not others.

I'm not sure if I should weigh in but I'm thinking of declining rad treatment come winter. I have 4 sessions of TCHP to go, however, I can turn down the Perjeta due to freakishly frequent D side effects. Following the TCHP, the plan is to get a lumpectomy in breast and lymph nodes to remove clips and anything that needs to go. After surgery, there's a good chance that radiation treatment(s) are in store for me. Of course, my lump, or what's left of it is right over my heart, so that's a concern. I also know a couple of others who are currently going through this type of treatment and they say it's no picnic.

I can't see the forest for the trees thanks to current side effects that make me want to give up treatment altogether. I'm a bit sick of taking the drugs for the SE. It's not easy to work and deal with this.

UPDATE (12/14/17): It's been 4 weeks since my last full round of chemo and 1 week since just Herceptin. The last two full rounds came with worse side effects that made me loose a bit too much weight all at once. I also got past all that, got an MRI and it looks as though the lump is gone! The armpit nodes look much better too. They're making it sound like since I opted for chemo before lumpectomy, I have to have radiation after surgery. They're not specifying which kind since we have to wait for test results during surgery. I wonder what they're going to tell me, like the odds of not having rads.

I have more news. 9 days ago, I had my lumpectomy (post chemo). They took out a tiny bit where the lump was and 2 lymph nodes that absorbed some of the dye. There was no cancer found in the nodes, the lump or the margins. WooT! Yesterday, I saw my surgeon and she told me that my odds of recurrence of cancer (in 10 years?) if I did not get radiation treatments, would be 25 to 30%. Compare that to if I do, 3 to 5%.

Next Friday, I'll see the rad doctor to see what my choices of treatments are. I'm really hoping to keep working, but I'm naturally concerned about possible side effects. Having experienced fatigue from time to time while on major chemo was not easy to deal with.

Hi Sweetpea and I'm glad you got some good news. I worked all through radiation, although like Gigibee I did not have chemo beforehand, so your fatigue may well be higher. Happy to help with more info if I can.

And for others interested in when you can skip radiation, Johns Hopkins is running a clinical trial to figure that out. I believe it's open to post-menopausal women 50-69 with small, ER+ tumors. It's called the IDEA trial and here's some info:

https://www.hopkinsmedicine.org/kimmel_cancer_cent...

https://www.hopkinsmedicine.org/kimmel_cancer_center/research_clinical_trials/clinical_trials/search_results/J1564

Looks like my assigned RO only wants supine position rad therapy for meand for six weeks The 2 sentinels and the original mass were negative after chemo, but they want to focus on the lymph nodes and also zap pretty much the entire left breast. They had me practice holding my breath and did some mapping.

I'm having trouble trying to find studies (online) which show comparisons between patients that get radiation and those that don't. The one that stands out (and doesn't apply to me yet), indicates that elderly BC patients would not benefit as much from rads since most of them (in the study) may have passed due to an unrelated illness or some other way. I know you can take these studies with a grain of salt. I also found what may have been a study (not a major one) where the patients were given 3 weeks of treatment instead of 6 weeks. The article mentioned that further study is needed which is probably why the six week regimen is the default most places. Most of the studies or stats that I've found so far are a bit dated.

I realize it's possible that surgery doesn't get it all. Also possible it could pop up elsewhere. So, I made an appointment to see a different RO (they asked for all my BC records but I'll have to wait 9 more days to see her.

I wonder if there's a study for women (in their 50s) who had roughly what I had, got chemo first, then had a lumpectomy (with minimal nodes taken) and didn't get radiation. Or, instead of radiation, endocrine therapy. I was postmenopausal before my uterus was removed (jan 2017, benign).