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

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. 

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? 

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?

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.

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

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