First post

Hey there,

It's been a few months since you'd posted and wanted to see how you are feeling and faring, about 2 months out from your final radiation treatment? I hope you are managing well emotionally and physically. It sounds like you have been given a stage 1B diagnosis? Would that be correct?

I too, had a nearly 4cm tumor (among 4 other smaller ones) in the left breast and ONE lymph node involvement (determined during surgery)- also ER/PR+/ HER2-. I went for the double mastectomy and had 4 nodes removed.

It was determined chemo wouldn't have a significant benefit, but hormone therapy and lupron to end my period was recommended, as is radiation - 5 weeks. I was prepared to do all three of the latter, and am having second thoughts about undergoing radiation, as mine would be to the left breast (some potential implications to heart and lungs down the road - among other risks I was gently alerted to during the consultation) and I have zero breast tissue left. Just skin and tissue expanders under the skin.

I'm trying to decide on radiation one way or the other.

Wondering how you're feeling?

I wish you continued improvement and fully restored health, Cheerful. :)

This is most interesting that I will now need to check into my thyroid baseline condition if I have a lumpectomy and radiation. Also my heart and lungs. I'm currently on Herceptin and Perjeta for HER2+ which can damage the heart. Ecocardiograms used to monitor this. I'm ER/PR- and stage 2A, grade 2. Taxotere chemo which I'm currently on also will hopefully reduce the tumor size, which is 2.8cm, so lumpectomy is possible on my left breast.

I'm considering asking for a referral to the local Proton Therapy Cancer Center to see if I'm a good candidate instead of traditional radiation since it's much more targeted to avoid the heart and lungs. MD Anderson and other Cancer Centers use it for Breast Cancer. If you have this option locally or nearby I'd suggest looking into it. Fingers crossed I'll qualify for this new and exciting alternative to radiation. Trying to minimize the collateral damage is key for me.

I will be getting an updated Ultrasound in mid-late December, midway through chemo, to see if Tumor has shrunk since this is what my surgeon will use to recommend path forward. If lumpectomy and radiation then I will ask then for referral to Proton Therapy Cancer Center. Will keep ya'll posted. I'm in the Central Plains as an FYI for location, and we're lucky to have a new Proton Therapy Cancer Center here. Can't afford the travel and expenses to other places.

While all of this is never an easy process, something about the way you communicate makes me imagine you take life on with a half-glass-full mentality, and I feel a sense of shared hope, reading your words.

From my research, it may also be possible you are slightly more protected with your own breast tissue as an extra little barrier between the beams and your organs, plus if you were guided to take that deep breath in and hold for 20 seconds while radiation was administered.

Thank you kindly for your suggestion regarding risks to thyroid function - I have a second opinion appointment (I feel pretty sure he's not going to side with the case I've built up about forgoing radiation, but I need my own peace of mind I've expressed my concerns) and I'll indeed bring this up.

I wish you continued healthy progress and am grateful to hear you're doing ok. Thank you kindly for sharing.

My apologies - I didn't meant to indicate any risk of other cancers partial to proton radiation therapy; I'm referring to later-effect potential of radiation in general to cause other cancers such as leukemia, lung cancer as a result of incidental exposure - a risk deemed low by physicians but I personally weigh against a variety of factors and do additional research on. (I'm not solid with my own decisions yet.) With reconstruction particularly, I have seen studies tissue expanders present some additional challenges beyond cosmetic or infection complications; the metal port of tissue expanders, for example, may redirect the radiation off-course a bit, with the potential to administer greater or less effective dosages.

Here are a couple of resources I'd discovered:

1. https://protons.com/treatments/breast-cancer/benefits-treatment (Benefits of Proton Therapy Treatment for Breast Cancer)
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5505855/ - (Tissue Expanders with Proton Beam Radiation)

There are many additional scientific studies on breast cancer and various treatment benefits/risks with various participant criteria - I'm happy to share them with you in a message if you'd like, though they are research results tailored to my own specific concerns. The last thing I want to do is create any fear or influence of any kind - just support. I need to do this kind of diligence just for myself because I'm navigating this whole ordeal alone, I'm overwhelmed, and because I want to be sure I have solid answers to questions about the necessity of any of the recommended treatments before I undergo more.

Here's hoping you rub off on me! :)