Why radiation after chemo with IDC?
I'm currently in chemotherapy after surgery since my Ki67 was 30% on the removed mass.
Why the heck do I need radiation after this if I'm killing all my cells with chemo????
Comments
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It's to clean up the tumour site to remove any cells that may remain. I'm guessing you had a lumpectomy. The protocol is lumpectomy + chemo + radiation, OR mastectomy + chemo, with the mastectomy doing the "cleaning up." I was advised against radiation because of a preexisting medical condition, so I went the second route.
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Since chemo kills any remaining cancer cells in the body radiation seems overkill. Right?
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Its my understanding that radiation after chemo doesn't really improve overall survival rate and that is what I am concerned with. I had confidence in my surgeon getting clean margins and if I am going to have confidence that the chemo killed cancer cells all over my body, I am willing to believe it killed them in the breast also. In truth chemo is not 100% anywhere in the body so I understand the decision of others to take every bit of every treatment for peace of mind. But there are risks to radiation including lung and other cancers and for those of us with left side cancer there is a risk for heart problems also. Bottom line for me was that my oncologist was comfortable with my decision to decline radiation. One factor in my case is that I am over 70. Its a personal decision and there is no wrong answer. Polly
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I had chemo, surgery, 35 rads. Surgery was BMX. Rads was to make extra sure no cancer cells were hiding.
Stage 3,grade 3, 11 nodes removed IDC
6 years later, no evidence of disease.
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Every person, and every cancer is different. Scientific research results are important to follow. Your treatment team should be able to guide you find what's right for you.
Chemotherapy and radiation therapy certainly have their role in helping to improve outcomes. It is very dependent on your personal situation; your diagnosis, what the doctors' recommend, and your personal life.
If we can help in any way, Please reach out to us.
With respect, and wishing all the best (please let us know),
The Mods
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I opted for mastectomies rather than lumpectomies for the single reason, I did NOT want radiation. However because I was Lymph node positive diagnosed during surgery, I had to have radiation anyways. I see you were lymph positive as well.
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I guess it comes down to what you're more afraid of-cancer or radiation
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Karen, It is a very good question. I know the standard of care after lumpectomy is radiation regardless of chemo. I believe you can choose not to have radiation. Sometimes doctors want to tell you rather than recommend. I know my breast surgeon would not do a lumpectomy if he knew I would not do radiation. Their primary concern is killing cancer. On my medical record, in notes reads patient refused chemotherapy. My oncologist agree to continue to be my doctor even after I refused chemo.
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I think it's because there's a high risk of cells being left behind after lumpectomy, and also that ER/PR positive cells aren't always responsive to chemo. I had a ki67 of 60% and 1 positive node but wasn't recommended chemo because of my mammaprint results. Chemo wouldn't have helped me much. But radiation I did without hesitation because otherwise local recurrence was pretty high. She also radiated the lymph node areas which I appreciated. So even had I chosen mastectomy, still would have been sent to radiation.
I also have a close family member with a stage 4 recurrence after many many years NED, so I greatly respect the threat of recurrence.
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For me it’s all about minimizing the probability of recurrence. Both chemo and rads reduce it significantly.
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I asked two different oncologist that very question. I was told the radiation was to get any cancer lurking in the breast as the point of origin and the chemo got (hopefully) anything in the rest of the body. My MO said I have a 40% chance of the cancer recurring if I did nothing and a 90% chance of a cure with the chemo, radiation, and hormone therapy - lots of bullets to use for a triple+. I am going for the treatments even though I am very scared.
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Diagnosed with invasive DCIS in October 2017. Started A/C chemo in November and continued through December 14. In and out of hospitals in December 2017 for blood transfusions. I also have Crohn's Disease which worsened during chemo. In January 2018 went to ER and was diagnosed with intestinal blockage as well. I needed to have a bowel resection and a stricturplasty done. Procedures could not be done with active cancer. Hospital did sonogram and mammogram and found that four A/C treatments killed cancer and almost killed me. Lumpectomy done on dead tumor bed and then proceeded with abdominal surgeries. There were clear margins and no spread to lymph nodes. Lymph nodes (11) removed because chemo screwed them up. In February 2018 I saw oncologist who now sprung radiation on me. She told me that w/o radiation, breast needs to be removed. I saw radiation oncologist in April and was considering. Two days later, I am in terrible abdominal pain and go back to ER. I was diagnosed with an internal hernia and had to be completely cut open. I was sedated and not cognizant because of drugs that were given. I was released after twenty days and needed wound care. I am still healing from surgery. I suffered tissue trauma and am still in pain from surgery. There is deep scarring and no belly button. They certainly did a number on me. I could not see original breast surgeon as he is out of network. He did call in February (he had flu after he performed my lumpectomy) and told me that the results were very good. I ran into him during wound care visit and he recommended a breast surgeon in network. I saw her in November and she too said that w/o radiation, breast needs to be removed. She provided me with another radiation oncologist. I brought pathology report and slides and saw him in December. Once again radiation suggested. I have been through so much because of the internal hernia surgery and have no help around the house. I am 62 and live alone. I also had a mammo and sonogram (right breast only) two weeks ago. Although breasts dense, everything was normal. I have been through so much and almost died because of the internal hernia. Radiation oncologist did not specify what type of radiation. However, oncologist and radiation oncologist keep pushing theory that microscopic cancer cells may not have been taken out with lumpectomy surgery. I do not want to be in pain and develop redness, blistering or swelling. I do not want to slather on creams to prevent this. I am very fair, never in the sun and take Mercaptopurine which makes me more susceptible to burning. This all falls on deaf ears. I am afraid of what the radiation could do to me. I am also a D cup which is quite large. No recurrence testing ever done. There has been so much research done over the years, yet same old treatments. I did walk around with cancer symptoms for almost a year as I did not know what my symptoms were indicative of. No history of cancer in either side of family. Why push to kill microscopic cancer cells when tumor was dead after four A/C treatments.
Any help in coming to a decision would be helpful.
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Rhonaa, I just finished 33 radiation sessions on December 13th. I am VERY fair-skinned and sunburn easily - and have the scars from skin cancer removals to show for it. I just got somewhat pink during treatment, a little darker on the collarbone but that is starting to fade. It's not at all like how your skin would react to the sun. Putting a dab of lotion or aloe on one boob is not difficult, nor a reason to avoid treatment! I had another major surgery between my lumpectomy and radiation, so I do understand your frustration at going through something else.
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rhonna, it is your choice. After everything you have been through I can certainly understand you don't want radiation. You could go high surveillance like I was after refusing chemo. I had mammogram and mris, my oncologist saw me every 3 months the first year.
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