Does Radiation "Boost" Cause Worse Effects to Targeted Area?

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?

Both times, no. Follow what skin care recommendations your RO says. They vary.

I had few problems with radiation, including boost. Just got a little red and itchy toward the end. I am fair skinned.

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.

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.

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.

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.

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!

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.}

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.

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.

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