Why rads after lx if you had chemo to kill "stray" cells?

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BCat40
BCat40 Member Posts: 241
edited December 2021 in Radiation Therapy - Before, During, and After

I have a friend recently dx'ed with Her2+ BC. It was small and not in nodes but due to the Her2 she is having a long chemo regimen. She had a lumpectomy to remove the mass with clean margins and they are also planning radiation for her. I am wondering why radiation is needed after lumpectomy if one is already having chemo to address any loose cancer cells in the body. My understanding is that radiation is to kill off any stray cancer cells in the breast after surgery, and it seems redundant. I guess I would understand it if someone still had residual cancer after surgery and chemo.

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  • exbrnxgrl
    exbrnxgrl Member Posts: 12,424
    edited December 2021

    Yes, it is still possible to have residual cancer cells even after surgery. Even if doctors were still doing radical mastectomies, which are very rare these days, microscopic cancer cells can remain too small to be detected or surgically removed. It is also possible for bc cells to travel through the bloodstream so again, surgery wouldn't catch those. As for chemo, not everyone has a complete response to chemo. So yes, despite these treatments teeny tiny residual cells can still be lurking in one's body. It is an ugly reality of cancer.

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  • serendipity09
    serendipity09 Member Posts: 732
    edited December 2021

    Exbrnzgrl's explanation is right on point. My tumor grew and spread to my lymph nodes during treatment and then came back again after the double mastectomy. Had I had radiation, which they did not think was necessary at the time, I may not have had the recurrence. Notice I said "may not" as I'm sure you're very well aware, nothing is guaranteed. Wishing the best for your friend.

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited December 2021

    Yes - I agree. Particularly since you say she is HER2+. Rads is so much easier than chemo...

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  • ThreeTree
    ThreeTree Member Posts: 709
    edited December 2021

    One thing too, that hasn't been mentioned here is that chemo is systemic and meant to get those cells that are out in far corners of our bodies, in addition to the local cells in the immediate tumor area. Radiation helps prevent a local recurrence, not a distant metastatic one.

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