Do I need radiotheraphy?

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1

I’m a slim, fit and active 62 year old who loves to be out doors playing golf and walking our dog. I was diagnosed with IDC Stage 1, oestrogen and progesterone positive, HER negative, size approx. 1.1cm, I was told it had been caught early and was not near my lymph nodes. I chose to have a single mastectomy (operation date 2/7/26) as I wanted to hit it hard and as I had hoped to avoid having radiotherapy and or chemotherapy. I was horrified at my post op meeting 3 weeks later to be told that one of the two sentinal nodes removed had a micromestastasis and that I needed to have a further axillary node clearance operation, this I had on 30/7/26.

At my latest post op meeting 21/8/26, I was told that my oncotype score is 20, that the further nodes taken (19) were clear. I was advised that I did not need to have chemotherapy but that radiotherapy would be scheduled for me because one sentinal node contained a micromestastasis

I’m concerned about having radiotherapy for the following reasons

  1. On left side - proximity to heart
  2. Heightens risk of lymphoedema, already at risk for to having axillary node clearance
  3. General burning and damage to skin, cancer risk.
  4. I have lots of cording in my armpit, elbow and wrist area and feel radiotherapy will not help this.

Grateful for views/advice.

Thank you!

2

Hi overwhelmed,

Thanks for your post explaining your diagnosis and asking if you need radiotherapy treatment.

It’s understandable you have concerns about the side effects of radiotherapy. For left-sided breast radiotherapy, treatment teams use planning scans and techniques to limit the dose to the heart as much as possible. Some people are offered deep inspiration breath hold, where you hold your breath for short periods during treatment. The aim of this is to lift your ribs up and outward, away from your heart.

Radiotherapy can increase the risk of lymphoedema. Your team can explain your individual risk and can refer you to a lymphoedema specialist if needed. Cording can also occur after lymph node surgery and may improve with time, exercises and physiotherapy. If you haven’t already, it can be helpful telling your team about the cording in your armpit, elbow and wrist before radiotherapy starts

Many people have skin changes during radiotherapy, such as redness, soreness, dryness or peeling in the treated area. These usually settle gradually after treatment, although some effects can last longer. Your radiotherapy team will give you advice about looking after your skin during treatment.

The small risk of radiotherapy causing another cancer in the future is something that treatment teams take into consideration when recommending treatment. They usually advise radiotherapy when the expected benefit in reducing the risk of breast cancer recurrence is greater than the possible risks.

We’re unable to say if you need radiotherapy treatment. Treatment is based on NICE guidance. Your treatment team can discuss this with you and talk through the benefits and risks based on your individual situation.

We offer a range of free supportive services which you may be interested in. They include face to face and online courses and events.

Do call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen, talk things through and signpost you to additional support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks.

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Best wishes,

Sonia

Breast Care Nurse

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