Whole breast radiation vs. pinpoint. Newbie here

NJmom2boys
NJmom2boys Member Posts: 31
edited August 2018 in Radiation Therapy - Before, During, and After

Hi,

I have Nuclear Grade 3 DCIS in left breast. Lumpectomy done this past week. Scheduled for radiation in about 4 weeks.

Met with the RO today and while she answered all my questions, it seems I have a ton more.

Based on my age (47), nuclear grade, size of DSIC (2.5 cm), clear margins, no family history...she suggests whole breast radiation. 4 weeks, last week is a boost.


I understand that radiating the specific area is attempting to kill cancer cells that may be lurking there. But why do the rest of the breast? Does this protect the breast long after the radiation? Or are they thinking there may be more cancer cells not detected by mammo, sono, and mri?

Also...I have very little breast tissue. I asked the doctor if I get a lower dose as compared to a woman with larger breasts. She said no, all the same That kind of doesn't make sense to me.

Any advice would be greatly appreciated as far as what to expect during the treatment. I go for mapping Monday.

I am traveling 2 hours each way to do the radiation, have 3 kids, and am a nervous wreck.

Thanks in advance,

Njmomboys

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  • Moderators
    Moderators Member Posts: 25,912
    edited August 2018

    Hi NJmom2boys,

    We are sorry to hear what you are going through. It is indeed stressful to balance life with treatments. We all know just how difficult that can be. We think that this section may be helpful to you to understand the different Types of Radiation and why they suggest one over the other. Hang in there and keep us posted!

    from the Mods

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  • moth
    moth Member Posts: 4,800
    edited August 2018

    All it takes is a single malignant cell. Cancer can spread through blood or lymph, so radiation is to kill any malignant cells that might be lurking in the area. They would be way too small to be seen on any scans because literally they might be single cells or very small clusters.

    Radiation almost always follow lumpectomy to reduce the risk of localized recurrence (the other option is a full mastectomy)

    Tufts has a calculator online which shows the % benefit in reduction of localized recurrence in the same breast when you do radiation post lumpectomy. If your RO didn't share the numbers she calculated with you, you can have a look https://www.tuftsmedicalcenter.org/ibtr/

    Come join us on the August radiation thread :)https://community.breastcancer.org/forum/70/topics...


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  • JosieO
    JosieO Member Posts: 314
    edited August 2018

    moth,

    MANY thanks for posting the link to the Tufts calculator-with just a few data points, one can easily see the difference between radiation vs no radiation.

    NJ mom2boys,

    I second what moth says. I had what was initially diagnosed as invasive ductal carcinoma, but upon surgery I also had DCIS as well as a cancerous lymph node.

    When the radiation oncologist described how he would direct the beams (like yours, whole breast with 5 days of boost at the end), I knew he was sending the radiation at all the areas where diseased tissue was found (and removed) to destroy stray cancer cells.

    For me, it was comforting knowledge.

    My radiation went very well, limited discomfort, and I feel good.

    Radiation in the hands of a skilled radiation oncologist is an excellent treatment.

    Best wishes to both of you.

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  • NJmom2boys
    NJmom2boys Member Posts: 31
    edited August 2018

    Hi,

    Thanks so much for the warm welcome and the responses. It is greatly appreciated. I have been reading a lot and I understand why my dr is choosing whole breast vs partial. I am at a top hospital and feel confident with my doctors. My mind is just racing with so many questions and I have learned so much from just reading on this forum.

    My doctor took a lot of time to answer my questions and explain. She did the calculator as well. I go Monday for mapping and she is hoping I can do it in the prone position. If not, I will do the breath hold.

    To add a monkey wrench in I have breast implants. (9 years old) so hoping I don’t get CC. Dr says nothing to do to prevent it, it may or may not affect the implants.

    I will be posting another question about that hoping maybe someone will share their experience if they had implants prior to radiation.

    Would love to join the radiation group. I start in Sept so maybe I should join that group?

    Thanks again,

    Njmom2boys

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  • Georgia1
    Georgia1 Member Posts: 1,321
    edited August 2018

    Hi there NJ. The advice others have given you is spot on, and many of us found radiation much easier than we feared. I loved my "posse" so second the suggestion that you go say hi over at the August group that Moth recommended - if you get mapping on Monday that counts as your start. All best wishes.

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