Rads and Lungs

I was worried about the same thing, but knew I had to do the radiation. When your radiologist does the CT scan setup he/she can tell you how much lung involvement there will be. The radiologist showed it to me on the screen and there was very little involvement and no heart involvement even though it was my left breast. Research has determined recently that some women over 70 can get along without rads --- but I wasn't over 70. Good luck

thisiknow, I'm 10 years out from radiation and have had no problems with my lungs. I had left breast, 2 o'clock. I also did the 16 rounds and it was so easy. Skin was fine and you don't go crazy having to go there so much. Good luck. Btw, I'm 73.

When I had my rads I had to take a deep breath and hold it to move my lungs and the heart out of the way of the radiation. Holding my breath was only for a few seconds. If I took in too much air I was told to let some out which told me that they can see prior to the dose where your heart and lungs are before giving you the radiation. I had no issues at all. I also had BC in both breasts at the same time.

thisiknow, with a lumpectomy, seems almost all ROs would recommend radiation.

The truth is, they don't know really know for sure what the dose will be to your lung until after they've done the simulation and devised a plan. It's dependent on your particular anatomy, so anything the RO tells you ahead of time is really just a best guess based on averages.

Do you know if they're going to radiate your nodes? Both supraclavicular and internal mammary nodes coverage increase the dose to the lung. So if you don't need those, that should help. Since you were grade 1 and node negative, you might not - especially internal mammary nodes if your tumor was lateral (on the outside of the breast.)

After the simulation, you can ask what the mean lung dose is, and also what the V20 is - what percentage of the lung is receiving 20 or more grays of radiation. The standard is to keep that number under 35%. Some think there is damage at 20Gys, others think 20gys is okay, that damage doesn't really occur until the dose hits 40gys or more.

I had lung damage after rads. But for reference, while my v20 was under 35% but my v40 was over 20%. No wonder I'm having problems. Also, they didn't put me on steroids when I had symptoms a month or two after rads.

Hope this helps, and good luck!

thisiknow - You really shouldn't have to educate yourself on dosages. That's what the doctor is for. I just had a bad experience, but I believe it's not common.

There are three sets of lymph nodes that breast cancer usuaIly spreads to. Most common is the axillary nodes - the ones under your arm, and where they did the sentinel node biopsy. It can also spread to the supraclavicular nodes, which are above your clavicle (it's at the top of your rib cage, running toward your shoulder.) And the third group is the internal mammary nodes, which are basically behind your sternum. Parts of your lung are underneath the latter two groups, and a small portion of the lung may get radiation when they cover them. But please know it's usually fine! And because your tumor was small, Grade 1 and you had negative nodes, they may not radiate your nodes anyway. If they were, the order would probably say "whole breast and lymph nodes."

So please don't get too worried! Just ask them when they do the set-up. If they say they are covering the nodes, and you have a pre-existing lung condition, make sure your RO knows it. Never presume s/he is aware of it.

Best of luck to you. You should be fine!

Absolutely no SE’s. RO’s have different techniques and different technologies to work with. So comparing is not relevant. But it is overwhelmingly in your favour that you will not suffer SE’s. it also depends on your health coming into rads. Lots get blamed on rads that may not be associated at all. All the best.