starting chemo after radiation

Hi Everetta,

I am currently undergoing chemotherapy AC-T. My lumpectomy was in September 2018. I had radiotherapy about 5 weeks after surgery. Just as I was beginning radiation, my MammaPrint results came back, and chemotherapy was necessary. I was 12 weeks post surgery when we began chemo. Your MO will be able to advise you regarding the recovery time between radiotherapy and beginning chemotherapy. Normally, chemotherapy is most effective within 90 days of surgery or 120 days of diagnosis. But definitely check with MO to help decide on what is best for you. Have you done a genomic test such as OncotypeDx or MammaPrint to help decide on the benefits of chemotherapy?

In my case, chemotherapy was part of my treatment path because of my MammaPrint results. I had also sought a 2nd opinion regarding MammaPrint results to confirm that chemo was necessary.

Hi Everetta,

I am 48. Yes, I believe under 50 my MO would most likely recommend chemotherapy even if my MammaPrint results came back somewhat lower.

Originally, my Breast surgeon who delivered the news of my diagnosis, said she didn’t think chemo was necessary. My tumor was 2.2 with no lymph involvement (stage II, grade 2) and BC subtype was ER+95%, PR+95%, HER-, hence; Lumpectomy with radiotherapy and then hormonal therapy would have been my treatment path. But I was adamant on a genomic test to see if chemotherapy would be necessary. And it came back high risk. I’m not sure if my age or any other factors came into play, but MO felt certain chemotherapy was to follow after radiotherapy. I asked for a 2nd opinion from Antoni van Leeuwenhoek hospital, which is the top cancer institute in the Netherlands, and the specialist confirmed that chemo was indeed the right decision.

Did your oncotype DX provide a TailorDX to help with intermediate score? I’m not familiar with oncotypeDX, but I thought I read that somewhere.

I’m not sure how much of a real percentage chemo would lower the risk factor for recurrence vs. the risk of not doing chemotherapy, but being quite fit and healthy and under 50, I concluded that perhaps this was the right choice for me.

As for chemo after radiation treatments, I asked RO if that was cause for concern, but she said that it’s not so much a factor. Radiotherapy is locally targeted and chemo is systematic (whole body). I began chemo almost 5 weeks after radiation, but that was due to waiting for 2nd opinion. I believe 2-3 weeks was the original start date. The only complaint of chemo after radiation is from my surgical site. Chemo may add further irritation/pain to an already beat up breast tissue trying to heal.

Not gonna lie, chemotherapy can be exhausting. Although, I’m managing through the side effects alright so far. Going to the gym at least once or twice a week really helps. I believe anyone who is active and relatively healthy regardless of age, would be able to handle chemotherapy. Though, that’s just an opinion. Your MO would be the best person to discuss benefits vs risks specifically for you. Everyone is different.

Hope I’ve been able to offer a little bit of insight.