Does Radiation "Boost" Cause Worse Effects to Targeted Area?
Comments
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Hi ladies who have been through radiation. I am deciding whether to proceed with radiation or instead just have a MX once surgeries at my hospital resume. I was originally supposed to have MX but it was downgraded to lumpectomy due to COVID.
I had a lot of tissue removed in the lumpectomy (I had my small tumor and a separate large area of LCIS/ADH removed). The RO said that the "boost" would be to the entire surgical field, not just the small tumor bed. So I am wondering if this means I am going to have a large surface area of skin problems because I am getting the "boost" to a large area of my breast instead of one small area. Did anyone notice worse skin problems in your boosted area?
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It didn't for me. It might have gotten a little darker but the boost wasn't a big deal.
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Both times, no. Follow what skin care recommendations your RO says. They vary.
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agree with the above, saw no difference with boosts. Strongly recommend following skin care advice. I am very fair skinned but followed care directions and essentially had no problems.
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I had few problems with radiation, including boost. Just got a little red and itchy toward the end. I am fair skinned.
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The boost sessions are aimed at just one area, not the whole breast. They're not any stronger than the regular sessions, at least according to the RO where I went, it's merely a smaller target.
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BCat40, I did have a reaction to the boost under my arm area. It was like a 2nd degree burn and very uncomfortable. It didn't happen until a week after my last session. After the peeling and the redness resolved the site turned a very dark brown. It can happen. I would discuss this with your RO. Maybe it depends on how many sessions you are having? Remember to hydrate and to use your lotion of choice. Best wishes.
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The boost comes at the end of the process on tissue that's already been disrupted, so it's hard to tell whether it's "worse," or if any more radiation at that point would have the same effect. I didn't find the boost sessions any different from the rest, but yes, my skin did fare somewhat worse at the end. But in total, I didn't have much issue with radiation. If I were choosing between having a mastectomy and radiation, all else equal, I'd pick the radiation. Good luck.
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Thank you everyone for your responses. I am having a really hard time deciding. I am only 40 so I should have a decent number of years ahead of me where I could possibly get a new breast cancer, and then I am severely limited in reconstruction options on a previously-radiated breast (don't have enough fat for DIEP, don't want to carve up other muscle groups). OTOH, if the full area of concern has now been removed w/ good cosmesis, it seems really drastic to proceed with MX anyway. Although, I was also told about the possibility of breast shrinkage from radiation and that could ruin the good cosmesis from the lumpectomy.
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I had a MX so never had rads, which means I don't have anything to add to the discussion except to say, "Don't you just love the choices we are faced with after a diagnosis of breast cancer?" Insert eye roll here.
Good luck with your decision. My only advice is that once you decide, know that you made the best decision for yourself that you could with the information that you had, and move forward. There is no benefit in ever second guessing yourself.
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BCat, I had thirty radiation treatments, five which were "boosts." I'm attaching a photo of my radiation plan which may help you picture how it works. Each of those colored areas are separate regions which received different amounts of radiation. That whole area, including my back, was quite red. See the green triangle toward the bottom on the frontal view? That's exactly how my radiation marks looked. The same goes for the orange marks peeking out from the bottom right on the side view, and that yellow corner up by my chin--that peeked out of every shirt I wore because it was late Spring and quite warm already.
The boosts were almost a relief when we got to that part, because it was essentially only my "breast" area. I wish I had a picture of it, but it was just an oval where my breast was. I have what my mother calls "Cheap Irish Skin," so by day 25 I was impressively red, to the point the rad techs would wince at me, but it is not a sunburn and did not hurt in that way, at least in my experience. So I found the boosts to be a breeze--the rest of the skin could start healing. I did every treatment possible, and other than the bother of going to radiation daily, I found it the easiest and least life-altering.
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Beesy (the other one), thanks for the pics. So the radiation presumably went through to your back. Did you have any rib, pec muscle or lung issues?
Beesie, thanks for your support.
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BCat, the radiation doesn't "go through" your body but the machine does move around your body. The following photo is helpful to explain how the rays avoid your organs--and that's the goal. I grabbed this photo off the Mayo site, but what it doesn't represent is how the machine goes underneath you and shoots the radiation upward also, so I drew it in with a black line--hardly a work of art but I hope it gives you a picture (the black line represents radiation as the pink rays shown).
The radiation techs at MD Anderson explained to me that the technology they use to protect your heart and lungs bears similarity to what the military uses with surface-to-air missiles. I had to hold my breath following a graphic on the ceiling and if it ever happened that I could not maintain the breath-hold, the machine would stop instantly.
I do not have any rib, lung or muscle issues, though I do have to stretch daily. Your skin is never quite the same--not so much how it looks but I've found it to get tight and need to be stretched regularly. I had zero choice about whether to do radiation but don't regret it. Within a few weeks after my biopsy, my tumor was growing quickly and an MRI showed it had grown into my nipple, meaning there was skin involvement and all my docs considered radiation necessary.
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Thank you Beesy. I have heard about the need for stretching. I asked the RO about it and she said that is usually for people who also have their armpit/nodes radiated, which I would not need. Did you also have your nodes radiated?
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BCat, while (by some miracle) it appeared that the cancer never got to the lymph nodes, yes, I got the full taco, so that may be the cause of my needing to stretch. My RO said that it would be something I would need to do for the rest of my life. I'm under 5 ft tall, so just reaching for things in my cabinets gives me an opportunity for a good stretch!
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BBCat40, I don't want to be be an alarmist but I did have a stronger reaction in the boost area area. I had a pretty strong reaction to the radiation in general, but definitely more so in the boost area. I can PM you pictures if you like, since I'm not sure if I should post them here. I also have fibrosis in my lung and it looks like I might have it in my esophagus as well- still waiting for those results. I did have the MX but ended up with radiation anyway, though this is not usually the case. I have been told by my plastic surgeon that implants are not a possibility due to the lack of elasticity in the skin, so it's diep for me when I get my courage up. Still, I think the skin looks pretty good now that I'm healed up. I am fair skinned and followed all instructions, including springing for the expensive compounded skin cream during treatment. There really isn't any way of predicting how an individual is going to react. As you see in this forum, many ladies go through it with no problem at all.
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whatjusthappened,
ugh. i see you were also blessed with both ILC and LCIS. I guess you had to have rads due to the positive lymph node? How many treatments did you have? They are telling me 16 regular treatments and 5 boost treatments.
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BCat40, I had 28 regular treatments plus 5 boosts for a total of 33. So you probably won't have the same issues with 21. I had radiation mostly because of the positive node. He had some kind of risk calculator that takes into account the size and characteristics of the cancer, number of nodes, etc. to determine the risk of regional spread. He thought my risk was too high, especially given my relatively young age (I was 48).
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BCat40, my radiation was to my breast, not on the other sides the way Beesy_The_Other_One had it. But I do have radiation fibrosis (basically scar tissue in my breast) and I have to stretch daily to maintain my range of motion.
I knew I wasn't a good candidate for staying on tamoxifen (I had huge reservations about it, tried it and sure enough no thanks) so I was all in for radiation. No regrets.
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I had lumpectomy. No nodes involved. I had 15 full breast treatments with 7 boost direct site. I didn’t see any difference in skin from either. I did burn but never peeled I used lotion , lotion and lotion. There are many great choices to use. In my case the Dr. recommended Miaderm. Good luck to you
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Seconding Miaderm. I got it from Amazon and I do think it helped mitigate the skin damage. I also got Eucerin but it's so goopy so I stuck w/ the Miaderm.
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Thank you to everyone who replied. I had a post-surgical mammogram today to see if anything was left behind. It was clean, so it makes more sense for me to proceed with radiation than going back for MX. I guess I will be joining the May 2020 Radiation club.
edj3, sorry to hear about your fibrosis. that is definitely a concern of mine, though I guess there is the pain/stiffness risk with MX as well so you can't necessarily win either way.
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Just saw the Mayo information and i am going for my positioning on Wed and start radiation for 15 rounds on the next monday. When i asked my doc about damage to heart and lungs since BC on left side she said i would be prone (on my stomach). Has anyone been positioned like that? Just curious, i did 4 tx's jof TC chemo with basically no side effects so hoping radiation will be the same. Thanks for all the information on radiation
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