Lumpectomy - no rads age 40

Sorry you're going through this. Not certain what you mean RO says you would "lose" 10% of your lung? The lung always gets some radiation during treatment, but it doesn't usually damage the lung unless the dose is pretty high - the stats ROs usually give is a 1-2% chance of lung damage. And what is the chance of a sarcoma? Does your previous experience with meds make you more likely to have complications than is usually the case?

Remember that radiation is primarily for local control, while chemo and estrogen suppression (for ER+ tumors) are systematic. ROs say there is still a systemic benefit - one stat bandied about is that for every four local occurrences prevented by radiation, one distant recurrence is prevented.

Sounds as though your BS is trying to protect you, and if you are ER+ and stay on tamoxifen that might give you the best chance of avoiding a recurrence. And my gut instinct is RO's usually advise radiation. But only your physicians know you and really know the science. I would suggest you get a second opinion with another RO. Just make certain they have your complete medical history. And your doctors should be able to give you recurrence-free stats with/without radiation and with/without tamoxifen, if appropriate, to help you decide.

Hoping you come to a place you are at peace with...

one of the stats you will often see is that radiation with a lumpectomy gives you roughly the same chance of “reoccurrence” in the same breast as a mastectomy (because that’s the theory that radiation will get any stray cancer cells). But of course we are all different no matter how similar we seem on the surface, there are always things that can make a difference in your treatment plan. For example there was an article that came out in June https://www.webmd.com/breast-cancer/news/20220607/some-younger-women-with-early-stage-breast-cancers-might-skip-radiation where they followed a group of women with a specific marker(or type of cancer) who didn’t receive radiation who were younger (in their 50’s) than previous studies and found that the majority of them did okay without radiation. That’s my long way of saying while you might not find anyone your age on the board who has skipped radiation that doesn’t mean it’s not a possibility. Wishing you peace in whatever decision you make.

Hi Love4Future,

I was diagnosed earlier this year with DCIS, and I’m 39. I understand how hard this decision is, and so sorry you are going through it. After lumpectomy for LCIS when they then found DCI, I asked my surgeon if I could forego radiation, her response was a hard “no.” Her exact words were that it is the “current standard of care.” I never got a second opinion, though, and I also don’t have any other health concerns. My family history with BC is really bad, and getting a DX of both LCIS and DCIS at this age led me to opt for a bilateral mastectomy, which I had a few weeks ago. Please feel free to reach out if you want to chat further. Sending all the best.

quietgirl, thanks for posting the link.

Some points from the study -

"Gene testing helped doctors identify a group of women who skipped radiation therapy because their cancer showed very low risk of coming back following surgery, according to findings presented Tuesday at a meeting of the American Society of Clinical Oncology (ASCO), held in Chicago".

five-years of follow-up

Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

Love4future, I would definitely suggest getting a second opinion from another radiologist. Good luck!