Partial vs Whole Breast Radiation

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kec1972
kec1972 Member Posts: 269

Hi All,

I am scheduled to meet with my radiation oncologist on 1/28. Just wanted to run something by everyone, my tumor was confined to just the portion of breast where the lumpectomy was performed. Per the MRI, the remainder of the breast looked healthy and normal. Is this a case where they would do partial breast vs who,e breast radiation? Of course I plan to ask the doc, just wanted to get some thoughts. Doesn’t seem necessary to radiate the entire breast if the rest of it is healthy? Thanks so much Kare

Comments

  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited January 2019

    kec...there are many threads here regarding partial and whole breast radiation. My suggestion to you is to speak to the radiologist and get a second opinion. I was offered partial but chose whole. When I had to decide almost a decade ago, though insurance would pay for either, there just wasn't enough evidence, FOR ME, to show that partial was worthwhile.


    Another point that I would like to make is that i do not put much stock in ANY imaging. Imaging may not see rogue cancer cells in the breast. That's why whole breast radiation made sense to me.


    Off topic, but something that stresses my point about imaging....last year I had my hip replaced. Prior, the x ray said I had the hips of a 40 year old ( I was 60) and NO arthritis. I ended up having 3 MRIs. None showed the true extent of the arthritic disease in my hip. It was SEVERE. Afterwards, I had asked the surgeon why the MRIs weren't accurate. His reply was that there are numerous variables. The machine, the technician, the position of the body AND finally, the anatomy of the patient, ALL affect the imaging results.


    That experience underscores my lack of faith in imaging.....AND, getting back to my BC.....I had a palpable lump AND the diagnostic mammogram MISSED it. A diagnostic sonogram found it......


    Here is some interesting info....

    https://www.mdanderson.org/publications/oncolog/hypofractionated-partial-breast-irradiation.h17-1591413.html


  • Georgia1
    Georgia1 Member Posts: 1,321
    edited January 2019

    Kec, I looked into this too and decided on whole breast. In my case, the malignancy was on my right side, so the benefits of partial in protecting the heart weren't applicable -- and my docs explained that the cosmetic results aren't very good. But pros and cons for you may differ.

  • AliceBastable
    AliceBastable Member Posts: 3,461
    edited January 2019

    I had all the standard imaging and tests before surgery: mammogram, ultrasound, biopsy, CT scan, MRI. NONE of them detected the micromet in the sentinel node that was found in the post-op pathology. And I wasn't given a choice, really, on the radiology treatment. I had been told 22 sessions at my first meeting with the RO, but that changed after the set-up session to 33. When I questioned the RO, he explained that it's all based on breast density, depth of tumor bed, and other factors that show up on the set-up scan. It's not done on "Oh, let's just go with this plan for fun." When I then asked about heart and lung safety with one of the zaps going to my back (I had a leftie lumpy), he further explained how the rays are plotted to create a geometric bend to go around those organs, which is why it takes about a week between the set-up and the first session. There's no way I would presume to know more about a highly specialized field than the radiologist does.

  • kec1972
    kec1972 Member Posts: 269
    edited January 2019

    Alice, that's good information to have. My lump was also in the upper outer quadrant of my left breast, so I am also tremendously worried about heart/lung involvement. I do think that radiation treatment has improved significantly over the past 20 years, so I'm hoping they have found ways to avoid getting the heart/lungs.

  • SunnyVA
    SunnyVA Member Posts: 1
    edited February 2019

    I am a candidate for Accelerated Partial Breast Radiation therapy - multi catheter. I would appreciate comments from people who actually had this procedure regarding the pros and cons, i.e. are you glad you made the choice for partial breast radiation, procedure to insert catheters, anything you can share to help my anxiety. I need to decide soon. Thanks


  • NJmom2boys
    NJmom2boys Member Posts: 31
    edited March 2019

    Hi,

    I just wanted to chime in on the left sided breast radiation. Mine was left sided, and I was also worried about heart and lung. The RO had me lay face down for my treatments which allowed the radiation to totally avoid my heart and lungs. She showed me an image of my breast/body that showed where the radiation would hit and where it would not. ( She also mentioned doing a breath hold if the laying face down didn't work (it all depends on your body/situation) and a simple thing like doing a breath hold can also help avoid the heart and lungs.)

    Personally I wouldn't feel comfortable with doing just a partial radiation due to that unknown factor of if there are any cancer cells that just can't be seen. My RO felt the same way. But she did tailor my radiation to my body, my cancer, and I just loved her.

    As a side note I had 3 weeks whole breast, and then a boost to the cancer zone for the 4th week. Don't be afraid to ask a ton of questions.

    Best of luck,

    NJ

  • cassiecanada
    cassiecanada Member Posts: 166
    edited March 2019

    Hi there Kec1972

    new to “ board" and learning to

    navigate- in meantime, your situation, age

    surgery and results are near identical to mine.

    I am pondering partial radiation- but

    it may not happen for 10 - 11 weeks out from

    surgery. So, first off, how long did you

    wait for rad and what did you decide?

    did you hear of any concerns waiting

    11 weeks?

    thanks

  • AMLMom
    AMLMom Member Posts: 102
    edited March 2019

    Hi,I just had my first meeting with my radiation oncologist, and asked this very question. She said that whole-breast for my age (46) is the standard, and that partial is typically only used for older patients with small tumours.

  • cassiecanada
    cassiecanada Member Posts: 166
    edited March 2019

    interesting- I am in the grey area I guess

    ( 63 yrs )- I had heard 70 years old was

    minimum age to go with partial. I want

    partial with such a small tumour (6 mm)

    irradiating the entire breast seems like

    overkill at my age. i have a very low risk

    of recurrence and a low grade tumour

    stage 1b...The only thing stalling me on this

    is imagining a rogue cell in the untreated

    part...Your situation sounds appropriate

    for your age ( 40’s)..

    Has anybody out there waited 11 weeks for

    radiation

  • LisaDCIS
    LisaDCIS Member Posts: 12
    edited July 2019

    Hi. Newly dx w/ DCIS left side here... at 40. Has anyone had experience with IMRT- the partial breast irradiation that is performed once a day, every other day over 9 days, for a total of 5 rounds? I know only a handful of clinics in the US do it right now. Cleveland Clinic is where I learned about it last week. I'm trying to decide between that and whole breast over 3 weeks.. then delay tamoxifen for a year in hopes for a child (just got married in May- testing out the in sickness and in health part right off the bat...) Then into the standard 5 yr tamoxifen.

    I'm opting for lumpectomy and only have 1 small spot per al the scans. Problem is I'm very small chested (34A) and thin in general. And my spot is in the inner upper area, so where the tissue gets even thinner. They said I would have trouble with dimpling, which is very troubling to me. And that radiation would make that worse. So I want to do what will give me the best cosmetic outcome. Any thoughts?

  • mysticalcity
    mysticalcity Member Posts: 206
    edited August 2019

    LisaDCIS I have not but would be interested in that myself. The shortened 5 round/9 day. Who at the Clinic are you working with doctor wise?

  • LisaDCIS
    LisaDCIS Member Posts: 12
    edited August 2019

    Hi It was w/ Dr Shah at Cleveland Clinic. I found out after surgery I am no longer a candidate for it as my surgeon rearranged tissue to try not to leave me w/ a dent. So partial is out of the picture and I'm very upset. Whole for me now.

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