Radiation or not and WHY? How to make this decision.

DeeMarie72

Hello Everyone. Thank you for taking the time to post in this forum. I feel that the biggest challenges with a breast cancer diagnosis--good, bad, worse--are making decisions. I am 44 years young and have no history of BC in my family.

Within the past two months, I have had regular and 3D mammograms on both breasts, a total of five biposies; three in left and two in right. I have had testing with all possible diagnostic equipment; Chest xray, breast MRI, MRI biopsy, Ultrasound biposy, Stereotactical biopsy.

My diagnosis: Invasive Ductal Carcinoma, one location, 8mm, left breast. Stage 1, Grade 1, ER +PR +HER2 Negative.

LUMPECTOMY RESULTS: Removed all cancer, clear margins of 4 mm or more. 

RADIATION RECOMMENDATION: Partial breast/Hyperfraction/Radiation therapy will treat from 4mm to 1 cm surrounding area where the cancer was removed, recommended due to my young age and the chance of it coming back in addtion to the fact that the doctor said that cancer cells may 'skip around' in younger persons versus someone who is 70 and the cancer cells tend to stay grouped. The reasoning for radiaiton is due to possible cancer cells created outside of the immediate area is was found.

HORMONE THERAPY: Suggested to be take fo 5-10 years and this slows or stops cancer cell growth in your entire body.

MY ISSUE: I am struggling with the decision to have radiation and hormone treatment and not just hormone treatment. I am trying to decide with the chances of side effects, infection due to a 5day treatment (cavity stays open all week long, you are given antibiotics to help prevent infection) and my inital thoughts are that I will get cancer elsewhere in my body versus in my breast.How to listen to your gut and make the best decision for you...

Does anyone have a SIMILAR diagnosis or maybe knows someone with a similar diagnosis that I can bounce things off with? I appreciate your comments and thanks for taking the time to read. 

meschellejensen

DeeMarie

Hi DeeMarie!  Welcome to this site!  If you want to bounce ideas off of me, I am happy to help.  My diagnosis is IDC left side,  stage 1A, grade 2, ER+/PR+  HER-. My tumor was 1.2 cm.   I had a lumpectomy in March and I just completed whole breast radiation on June 21st.  I also was offered the option of brachytherapy, but I chose whole breast radiation. 

camul

We can tell our stories

but if you are unsure, I would get a second opinion. You don't know other peoplesmed reasons for added treatments. But rads and hormone blockers are anormal combo for a lot of usi am stage IV And you certainly dont Want to be on hospice, with. brain mets, lung, bone and liver.  Get a 2nd opinion.

HapB

Dee Marie

It is so very difficult to make these decisions about treatment because there just is no certainty no matter which treatments we are given. Some do everything recommended and still have mets, and some do less and never have another issue. Cancer is a mystery and there is just no cure. That being said,  this is my third unrelated cancer. I am 6 years out from two cancers(discovered at the same time), which were treated with chemo, rads, and surgery.  So far, NED on those 2 cancers, but discovered this BC on a surveillance PET.   I am scheduled for radiation.  I know there are risks, but the choices are not good and that is the decision I made after weighing all the treatment options.  Some patients just do what the doctor tells them to do, and that is ok. Maybe you could talk out your concerns here? 

Beepositive

Everyone is Right..we all have to make decisions for ourselves and our situations are all different...My doctors were telling me a lot of options and I picked what I felt was best of me and my life!!  Keep asking your doctors questions and God Bless you ...Prayers and long life TO EVERYONE!! never give up...keep fighting!!

Beepositive!!!!

DeeMarie72

Thanks

Hey Everyone, It is nice to meet you and thank you for all your comments. I think it is comforting to talk about it--and of course, we all have to make our own decisions.  I am waiting to come to peace with my decison. I believe that we need to change our thinking, eating habits to make a change in our bodies and the doctors never really talk about that. They talk about doing everything to remove the cancer, refer you to the radiologist, medical oncologist but not a therapist or nutritional doc/nurse to discuss your eating habits, emotional state, etc. I am grateful that I have been involved in healing for many years because that is the tool box I am dipping into now as I make changes in my life.

With all that said, I don't want to live in fear that this will come back--I think that is something I have to come to terms with. Whether I do the radiation treatment or I don't, I believe I will have this fear (and I think I just realized that as I was typing)... 

Thank you for reminding me that we can do all this treatment and it may never come back or it may come back. I do not want to NOT do this treatment out of arrogance and that I think I will beat this cancer without addl treatment. I believe I can beat future cancer by improvig my emotional state, eating habits, etc. 

I am trying to come to peace with all that...  Sigh, thus is life when diagnosed with cancer.

 

Apaugh

DeeMarie

You do what is best for you.  It is your walk.  Remember, we are here for you no matter what your choices are. 

Hugs,

Annie

Kats2

Get more opinions Dee.....

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Hi DeeMarie,

I would get 2nd and 3rd opinions from Oncologists who specialize in breast cancer. This might help you with your decision.

Considering your young age, I personally would opt for the radiation along with follow-up hormone therapy. I wouldn't want to look back a year or two down the road and say,"Gee, maybe I should've had the radiation treatment." If you DO have a recurrence later,( and I certainly hope you don't!), you won't have any regrets.You can say, "I did everything that was recommended to help me not have further problems."

You can still change your diet, and engage in alternative therapies like meditation, perhaps acupuncture, etc. That would be a plus. Therapy can be had if you ask a Social Worker at your Cancer Center, also a Nutritionist. I went to my own as I didn't think the one on hand knew any more than I did! I also bought books on Cancer and  Nutrition which helps.

I'm a little confused about you talking about having an " open cavity" and the possibility of infection. I had 33 rounds of radiation and had absolutely no problem with it. I had a lumpectomy too and my tumor was even smaller than yours. It was something like .5 mms. I had no "open cavity" anywhere. Can you comment a bit more on that?

Anyway, it's your decision, but I would want more input from knowledgeable Oncologists before I made an important decision concerning the treatment of my breast cancer. Don't just go on gut instincts. Err on the side of caution. Wishing you well.  Kats2

P.S. What was the report on your lymph nodes? Did you have a sentinel node biopsy at the time of your lumpectomy or an axillary node biopsy which is under the armpit?

HapB

Kats

Good advice. BTW, I had SNB, which was under the armpit. Aren't they all?  

Mariangel43

Hi, Dee

I also have IDC but my tumor was big.  The MRI showed a mass of 9x6x8 that was reduced to half the size with hormone therapy in less than a month.  I also had an affected lymph node with less than 1 mm.  I didn't choose rad therapy because I had a simple mastectomy and the pathology report showed that skin and the rest of the tissue was not involved.  Also, guidelines for MX patients did change and I asked the ROs if they could give 40 Gy in 16 fractions but they said no.  One wanted 60 Gy/33 fractions and the other 50 Gy/28 fractions which I found to be too high for me.  

I am looking for oral chemotherapy but my MOs are too traditional.  Near home I have a Cancer Treatment Center (lucky me) and if they give me oral chemo or immunotherapy, I will drop the others docs.  

Just check for the side effects.  If the risks are too high, then you should evaluate whether is necessary or not.  In your case, you had a lumpectomy and is traditional procedure to radiate the area.  Consult with your docs.  

I am sorry the next words will hurt but must be told.  No radiation or chemo will guarantee that the cancer is not coming back.  The probabilities of cancer recurrence goes down but it is never 0. 

As for the bills, they keep on growing.  I had a very good health insurance plan but it increased my monthly prime, deductibles and copays.  I had to pay $180 for one ten-session physical therapy to the hospital.  I still owe three more. 

Take care and please keep in touch.

Kats2

HapB said:

Kats

Good advice. BTW, I had SNB, which was under the armpit. Aren't they all?  

Sentinel Node Biopsy

Hi HapB,

A Sentinel Node Biopsy is not done directly in the armpit. It's done on the side of the armpit, away from hair growth. It's being done more now than the axillary node biopsy. Supposedly if any node shows up positive there, the breast cancer has already metastasized.

                               Kats2 

Teach76

Just adding a thought to consider. . .

When I was given the option of radiation I was first told that the hyper fractionated might be a possibility.  After my MRI I was told full radiation was necessary.  If they are saying that cells were found outside the treated area, I would think the option would be to radiate the entire side, not just a few mm around the removal.

Like most of us, if you are comfortable with the explanations given and you have trust in your doctors, follow their advice.  If you still feel unsure after a full explanation is given, seek another opinion.

i remember the consultation with 2 surgeons when I was first diagnosed.  They had 2 completely different approaches to treatment, but both agreed I should see the oncologist first.  

Kathy

HapB

Kats2 said:

Sentinel Node Biopsy

Hi HapB,

A Sentinel Node Biopsy is not done directly in the armpit. It's done on the side of the armpit, away from hair growth. It's being done more now than the axillary node biopsy. Supposedly if any node shows up positive there, the breast cancer has already metastasized.

                               Kats2 

Kats2

Hi Kats2,  I am a little confused.  I had a SNB and it is smack in the middle of my armpit. 

 

disneyfan2008

I too had NO family history

I too had NO family history of BC and it seems like I read on this site many in the same boat.

 

I did radiation-post lumpecomty. I personally never considered not doing it.

 

Denise