Partial Breast Radiation
I have had 7 out of 16 radiation treatments using partial breast radiation. It has never been done before in my home city Cancer Centre. They are having a lot of trouble aligning me , my actual treatment appointment takes anywhere from 20 but most often 40-50 minutes ! I have also had at least 7 xrays. As Ihave a lowvrisk for recurrence type I'm considering stopping for many reasons. Any personal experiences or information or advice would be appreciated.
Comments
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Hi mary liz-
i am also due for partial radiation ( next week)
and was told that setting up is trickier.
I chose partial because i was low risk...
age, tumour type etc. and i dreaded
idea of whole breast radiation for a small
area... what was your radiologists rationale
for partial vs whole or was this your decision
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Hello Cassie,
The partial breast radiation was my idea. I wanted to have brachytherapy and was a good candidate for it but after bits of information I found out I’d need a general anaesthetic which is not for me unless absolutely necessary. My 2nd choice then was partial as I had a solid papillary carcinoma in situ 0 stage ( precancerous) only 3% of all breast cancers and I read small tesearch studies online that showed no difference in the prognosis with or without radiation ( still good) even for invasive and mine was non invasive. Maybe I stated that invorrectly for invasive the same number of patients did well or not and radiation made no difference .
My surgeon said ( even thpugh I had clear lymph nodes and clear margins) that I still shpuld have some radiation and my radiation oncologist said 16 treatments. I’m seriously considering stopping soon for many reasons
I am the first patient at this Cancer Centre in my home city to have partial but my oncologist support ed the decision . I woild ask how many patients they have had previously but I wouldnt let it dissuade me as I do think that I would choose it again..
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that is very interesting and thankyou for
the info! what is brachytherapy? It
sounds like our pathology is different, yet
there seems to be a similarity in recurrence
rate regardless? i wasnt too clear on
the part you mentioned where those
with invasive had same outcome as non
invasive?...radiation to full or partial
made no difference?
i find this intetesting/-literally mothing out there
on this.
i know what you mean about general
anasthesia- i had managed to avoid it my
whole life! but the beast within gave me no
choice but to go under... ugh!
it sounds like you had only radiation?
( no surgery?) for your situation
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Hi Cassie,
Brachytherapy is a type of radiation, the surgical insertion of extremely small microbeads that provide low dose radiation in a very small atea where the tumour was for about two months then stop. The microbeads stay there the rest of the patient’s life .
I think the way I worded my problems with general anaesthetic in such a wsy that you thpught I didn’t have surgery but I did. Mid December I had a lumpectomy and sentinel node biopsy ( 3 nodes).
My GP told me to google the exact type of tumour that I had and add the words “and treatment “ at the end and that’s how I found the three studies. There was no mention of whether any had full or partial radiation just that there was no difference in the outcome with or without radiation.
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Thx Mary Liz- sounds like your med team
is really on top of stuff. I plan on asking
my radiologist tomorrow about
risk of recurrence with partial
vs full. It sounds like you are halfway
through your rad treatment. I
can understand your concerns
given the length of time for set up
etc. If it were me, and I could very
well face the exact same scenario
next week, I would try and “ stay
the course”... prob cos I wouldve gone
that
far and may felt the treatment
incomplete . Radiation post
surgery has a certain window of optimal
effectiveness-
as well, I kmow i most likely wont
take femara after because the side
effect issue is alot to face with such
a low recurrence rate...
Are you going to be taking tamoxifen
or femara etc after?
I am fairly new to this site so
havent figured out how to add
pathology:
but my diagnosis was idc stage 1b, clear
nodes with wide margins...plus 10 mm
idc in situ.
Another thing to ponder: because
this is a relatively new treatment
choice in your area- it sounds like
they are being very thorough..
how do you feel? my radiologist
said partial should, like full, be
slightly pink and may have a slight
tingling or sun burned feel.
As this week goes by, perhsps
express your hesitation with
proceeding . perhsps let them know
before you start if more xrays etc
may be needed..etc
sorry- i am not that helpful. but
like i said- this may be my scenario
next week and I am trying to
put myself in your shoes- its just
easier ssid than done- i face these
doctors and always draw a blank-...
i need to work on that
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Hi Cassie,
My reason for questioning continuing is not the set up time, I’ve grown used to that now but I don’t like the idea of multiple xrays. Here it’s routine to have a CT scan and xray for the planning appointment and then xrays for at least the first two treatments since they had to replan for me that has meant 6 xrays plus 2 more as they can’t seem to do the alignment without an xray and then my oncologist looks at it and then they do the radiation. As I’m really low risk ( My terminology based on everything I’ve read) I wonder if all this extra radiation from the xray is worth it. Also since it’s my left breast i have some concern about my lung and heart . My doctors did not recommemd any hormonal treatment like tamoxifen or other which i am grateful about. So far my skin is holding up well. I slather on a lot of an aloe vera cream twice a day ( not on the recommended list) but I also use a bit of calendula cream. In addition my homeopath has given me a radiation side effects remedy that i take each day of treatment ( not at all mainstream). I do feel some heat and very mild pain internally now though.
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What I hate so much in the hypofractionated partial 16 rads is that they take 7-10 chest xrays before the rad begins. They do this each time to precisely line up the tumor bed and margins around it. I don't know, but doubt they do this with WBI. I asked if it would cause new cancers in 30 years- of course I'll be 115 then.
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I , too, have hypofractionated and
its WBR-( 16 treatments). It is my
understsnding that this is standard
protocol . I told the radiology guy at
beginning ( bit strange at first to
have a guy, actually) that I was concerned
about this pre xray thing - he explained
its necessity and dose does not add to
total grays rec’d but rather included ( thats
my layman way of remembering)- fir
my own curiosity, now that its 3 weeks later-
i will mention this interpretation during
my appt and here it again to fully clarif
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I had whole breast radiation too. I had x-rays the first appointment and then after that once a week.
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Ok- so it seems prior xrays are par for the course, I suppose it depends
on the facility etc in terms of when
and dose etc- but i really went in to
it today with the rafiologist and it was
rxplained that my dose of .280
grays a day includes the pre xray dose
so there is no additional dose on
top of the usual total 40-42 grays
that many women receive.
Of course, the timing of these
xrays may vary from one centre
to the next- but in my centre
it is “woven in to”
versus “ added on to” to
the daily dose rec’d.... so the
grand tally will always be @42
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Thank you cassiecanada. This is really helpful information I will ask RO .whether mine is woven in
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For some reason I was not receiving posts but contacted moderators and reconnected so I'll join in again. My partial breast radiation here on the west coast in Canada was done very differently. I was only the third person to have this so maybe no real protocol which is a bit concerning. I had only two xrays at the first planning appointment where I also had a CT scan and a mold fitting. I was supposed to have one xray before each of the next three treatments and no more but I had so much more than that and I don't think this was factored into my total amount of radiation ( I just saying this in laypersons terms as no one called it what you are both referring to, with me). Each time they would have problems with alignment and I always had two xrays and sometimes three or four and then the radiation oncologist would come to the unit look at the xrays and tell them if they could proceed with radiation. I even had two extra planning sesssions as they were having so much trouble. Only two therapists out of about twelve seemed to have little difficulty but that was three days out of twelve ! My time on the steel cot was always 25-45 minutes ! In total I had between 26-32 xrays !!! After day 10 I expressed my real concern to oncologist and she said it was still a low dose... I'm very dubious as well and although Ihad very few side effects I did have a reddened area on the neck and upper chest not on my breast for two weeks after ! I wonder if they even radiated the right area ... and what will happen later on. I stopped after twelve of the sixteen treatments .
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I was told todayby technician that I’m getting 270 rads a day with the numerous each session x rays that I hate factored in. I’ll ask RO on Tuesday when I see him weekly
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yes- that sounds exactly like what i was told...!
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ps...just noticed my decimal in original
post should be 2.80 grays ( or 280 centigrays
or rads)
So my own total will be 16 days x 2.80 grays=
an accumulated dose by the end of @ 44 grays.
sorry if i confused you with that decimal.
So it looks like in your case its 270 rads
or centigrays ( 2.7 grays) x 16 = @43.2 grays
( or 4320 rads or centigrays)-
and yes- it looks like they also included the
xray dose in those dailies. I am no expert
and muddle thru like everyone else, but
hopefully i havent added any confusion-
its also helpful for me, because i was offered
partial radiation but decided against it
because i dont think i will be taking tamoxifin
or femara after. But it was very appealing
to me at first because less peripheral body
parts are radiated . I still wonder about my
choice at times, but feel it was best option
overall. Good luck with your chat with radiologist!
( I often wonder if they are surprised with some
of the questions/terms we present to them at these
appts...that we glean from all of this forum chitchat
haha. Good for us!
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i see that you have posted a lot and I’ve missed it all, a bit disappointing that I was bumped off this forum for a while and didnt even know that a couple of you were posting. Is WBR whole breast radiation? What is hypofractionated ? I hope that your treatments are going well or maybe you are finished by now?
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I'm just posting here to let you know that after 10 years I have not had any side effects from radiation. My tumor was in my left breast at 2 o'clock position. I had about 19 rounds of radiation, didn't have any burns or blisters. At the very end my breast was a little red. I'm so glad I could have the shorter version. I was also considering the 5-day 2xday protocol but decided not to do it since I was Her2+ And the didn't have any studies with her2 cohorts. The one thing I did was plaster Aquafor all over my breast and under arm like at least twice a day.My radiologist had bowls of the smallsamples of it.
PS Don't look at any of the equipment
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Cowgirl13,
I always keep my eyes closed. The equipment to me is like in a science fiction horror movie. Today was 8/16 hypofractionated partial. Then, arimidex. How did you do on it
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Wow, you are halfway there! With arimidex I had side effects pretty soon. I had pain in my legs/muscles butthe pain stopped. Seemed to coincide with Stopping eating sugar. And then everything was fine, more or less although I developed a bad depression. I stopped taking it after 7 years. It was fine about 80% of the time.
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Hi Mary Liz- wonder how you got bumped off ? I remember in one of your posts
you had expressed concerns about
the time/difficulty in setting up and were
concerned about the
xray dose. Now I see that you stopped
radiation altogether. That is really frustrating for you : and
to have those fears now. I am trying
to imagine what i would have done.
We want and need to trust the therapists and dictors but our confidence can be shaken if we see/hear problems such
as you describe...Did they ever discuss
options or did you just stop going?
I almost feel the radiologist
should have just taken over if
so many therapists were struggling..
or get help from outside esp if you
are in the midst of treatment..Hopefully
you teceived enough protection
ftom the amount that you did receive.
I decided to go with WBR ( whole breast
radiation) because i knew i would not
take drugs after. The deal seemed to be
that with partial, it was more important
to take the tamoxifin...
i have 2 more days to go
and strangely not pink nor tired in fact
zero difference in appearance. I
know its a delayed reaction but
having only 2 days left has me a little
concerned that by now there should be
some change. the machine broke last friday and i had a fear that maybe
it hadnt been running properly all
last week
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Hi cowgirl3,
Thanks for posting about your progress. I’m so glad that you are doing very well. My prognosis is good so I feel really positive ( and have all along once I knew what I had ) . My only convern is that my partial breast radiation was a real learning ecperience for my therapists and they had great difficulty with alignment which resulted in so many more xrays than they told me I would have. My Rad.Onc. was coming down my ladt 5 days and looking at the xrays before radiation. I slathered on aloe vera cream twice a day and had almost no pink skin issue. Right after I stopped on the 12th of 16 yreatments my neck and upper chest above my breast was read for almost two weeks, which sermed very odd.
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Hi cowgirl3,
Thanks for posting about your progress. I'm so glad that you are doing very well. My prognosis is good so I feel really positive ( and have all along once I knew what I had ) . My only concern is that my partial breast radiation was a real learning experience for my therapists and they had great difficulty with alignment which resulted in so many more xrays than they told me I would have. My Rad.Onc. was coming down my last 5 days and looking at the xrays before radiation. I slathered on aloe vera cream twice a day and had almost no pink skin issue. Right after I stopped on the 12th of 16 treatments my neck and upper chest above my breast was read for almost two weeks, which sermed very odd.
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Hi cassiecanada,
I'm not sure what happened but I could log in and read all information but never saw any posts and no emails either until today !
I just knew it was time to stop radiation after my twelfth treatment. I had told my Rad.Onc. that I'd go day by day after day ten when I had the third planning session. On day eleven it went much better but I had the two best therapists , just one xray first but then on day twelve again 45 minutes with four xrays first and I just felt that that was the end for me.
No, they didn't offer me anything else. I see my Rad. Onc. in 6 months for a recheck and mammogram. If I had known they would do 30 xrays I think I woild have just had whole breast radiation. The Rad. Onc. said at the end that she had told me first appointment that some women just refuse radiation with my type but she didn't say that. My surgeon who is very good said I'd need some radiation as follow up treatment and that was all, so she was referring me tothe Rad.Onc. who said I would need 16 treatments. To complicate matters before that first appointment I had researched brachytherapy and wanted that but after being accepted I found out I woild need general surgery and I have had two very bad experiences with anaesthetic so then that was out.
They were very careful with the anaesthetic for my lumpectomy and I was alright but I shouldn't have it unless no alternative.
Anyway due to the experience that Inhad with radiation I don't know if I should have had it at all due to the research reports I've read but what's done is done and I'm going forward in a positive light.
I am going to ask about my total amount of radiation that Inreceived though.
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