Hello everyone.
I had a lumpectomy for a small left sided (6mm) cancer in December, and have been referred for radiotherapy. However, I have cardiac arrhythmia and so have been given the choice of accepting or refusing the treatment due to the possible cardiac effects. Has anyone else been in this situation? Thanks for any thoughts.
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Hi @judyea and welcome to the forum. It’s a very supportive place.
I had bilateral (both) invasive breast cancer and needed radiotherapy on both sides. I had to learn breath hold to move the heart out of the way to minimise any issues. I was also having chemotherapy and Herceptin which are both cardiotoxic and affect the heart. I needed a MUGA scan 3 times over the year to check my heart function because I was having Herceptin for a year. This did affect my heart function (ejection fraction) but was still within normal limits and I was informed it will improve over time as well.
I also have Supraventricular tachycardia which is also an arrhythmia, this is controlled by medication but I occasionally get an episode of it. My team contacted my cardiologist who was happy for me to have the treatment. I needed the treatment to save my life and I knew my tachycardia would not kill me. I also have a family history of cardiomyopathy and this was taken into account with my treatment plan. I am also monitored with my cardiology team who did an ECHO at my last meeting for their own records.
If your team have not contacted your cardiologist ( I’m assuming you have one) I would ask them to do so or you could contact their secretary and explain the situation and see if you can get an appointment with them to discuss your own situation and radiotherapy.
Take care 
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I had 20 doses years ago. 15 normal and 5 boosts. This was before the newer breathing techniques that help move the heart away from the treatment. I was 36 and had no side effects at all. However, as previous poster said, a conversation with your cardiologist would be a great idea to be confident to go ahead. Best wishes.
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Thanks very much for your reply - that’s really helpful.
I also have SVT which is well controlled by medication. I haven’t seen ‘my’ cardiologist for years - or even had my meds reviewed! It is very stable and I just get the occasional flutter.
My cancer was invasive ductal, oestrogen +, Her 2 -, and i am now on Anastrazole and Adcal D3.
Because I am not 70 unil next year, I’m right on the cusp of needing/not needing further treatment - which my oncologist is leaving it up to me…
I have my planning appointment the week after next in case i do go for it.
Anyway, I’ll give the breast unit team a call tomorrow and see if they can get a cardiologist involved.
Once again, many thanks and best wishes.
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Thanks for your reply.
I am due just 5 treatments - it seems they blast you over a short space of time rather than drag it out these days…?
I don’t actually have an active cardiology team, but I’m going to call my breast care nurses tomorrow and see if they can get me some information/an appointment.
Many thanks for your advice,
Take care.
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After reading the replies to my question, andcto cutva long story short, I have at lat been referred to a cardiologist andcam having an ECG and an Echocardiogram. The different departments are now communicating with each other and i had a call from my oncologist the evening before mybfirst booked radiotherapy appointment to say i should delay the treatment. I am quite happy with this, but wonder why he didn’t refer me at the very beginning, instead of just telling me ot was mr decision. The moral of the story is, if you have doubts, ask for a referral immediately!
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Thanks for the update. Please they are all talking to each other so you get the best treatment.
If you have 5 treatments which I had then the dose is usually around a third less than if you have 15 treatments. There seems to be some confusion over this as my Oncologist initially told me that the dose was the same whether it’s 5 or 15 but someone from the Radiology team said was 26 or 29 gy ( I can’t remember which ) as opposed to 40gy for 15 treatments.
My tumour was very slightly larger than yours ER/PR+ HER2- and tubular which is a kind that rarely spreads. I was on a medical trial which stipulated I had to have the radiotherapy to remain on the trial but I was 56 at the time and would probably have had it anyway as I was more concerned about the hormone therapy. I also was on Anastrozole but my Surgeon said that it would be reasonable to stop if I didn’t get on with it because of the low risk. I didn’t get on with it and stopped after 5 months .
There’s slightly more risk to the heart if you’re having radiotherapy on the left ( mine was right ) and as previously mentioned you are taught breathing exercises to move your chest away from the heart so as to minimize this risk.
I would suggest finding out from the radiotherapy team the exact dose of radiation they are planning to give you and if it will be whole breast radiation - through reading and participating in various threads on here I’ve come to realize that there are options and perhaps the Nurses on the helpline here might be able to give you more information .
I hope you are getting on ok with Anastrozole and it might be worth asking your Cardiologist about how that might possibly affect your heart as well as you will be on it for 5 years. Hopefully you and your Drs. between you will come to a decision as to whether you would be better off with just radiotherapy or just hormone therapy rather than both. As you get older and your medical history becomes more complex the risk / benefit ratio isn’t always clear if your cancer was low grade and as small as yours . The decisions are never easy to make . Xx
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I had radiotherapy for 5 days and was told it is at a higher dose than over 15 days.
40gy/15 is 2.67gy per day whereas 27g/5gy is 5.4gy per day . So the daily dose is higher and the side effects can kick in quicker. Overall 15 days is more radiation in total than 5 days for one sided treatment.
I had bilateral radiotherapy so had 10.8gy per day (5.4gy per boob) over 5 days with a total of 54gy over my full 5 days.
A trial looking at giving 1 week of radiotherapy for breast cancer (FAST-Forward) | Cancer Research UK this cites 40gy or 26gy or 27gy
As always our treatment is individual and if you have any questions check with your team.
I have had the planning appointment, and have practiced the breathing technique - 20 seconds doesn’t sound long until you are holding your breath for that long does it? I’m having my whole breast treated, so ne
ed to do everything I can to stay ‘safe’. I don’t know what dose is planned, but I’ll have time to find out as my ECG etc aren’t until next Friday, then I’ll have to see the cardiologist for that opinion. I am on Anastrazole as I said, and it’s not too bad, except I do get more aches and pains - especially my back, but I can usually walj ir off… Anyway, I’ll see how things go, thanks to everyone for their input…
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Yes I can do that sort of breathing in Yoga but it’s hardly the same situation. I’m glad that you’re getting on ok with Anastrozole and I wish you all the best going forward whatever you decide. Xx
I have found that when I ask about specifics, I’m always told the treatment is tailored to the individual…
Yes it’s all individualalized. Some have radiotherapy to the breast, others add in chest wall, others add in armpit (axillary) and others include the collarbone.
So it’s not just the amount they give but also the areas that are treated.
I found they don’t like to talk specifics but if you’ve done some research I found they would answer. Some things I’ve found out after it happened.
Mine will be the whole of the left breast, which is why i wanted to be sure my heart is protected…
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I was bilateral (both boobs) so I did breath hold on both sides to protect my heart. Chemotherapy and Herceptin for me were also cardio toxic. It’s the downside of our treatment, especially if you have a heart issue already or a family history.
Reading other womens’ experiences, such as having bilateral tumours, makes me feel very fortunate in only having one very small lump - but I’m certainly not being complacent… Are you now ‘cancer free’?
I have been ‘cancer free’ since my operation in July 2023 but as I then followed with chemotherapy and Herceptin it didn’t feel like it. It has taken some time to come to terms with it and my annual mammogram was able to confirm cancer free.
I don’t think any of us are fortunate having a breast cancer diagnosis, but we are all fortunate to have treatment that can help us to be cancer free or manage it as a chronic disease. But we do know that some of us will be unfortunate as the treatment will stop working. Hopefully BCN/Cancer Research can improve treatments so that no one be in that situation.
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Treatment is definitely improving all the time, thankfully… It’s also definitely quite individual - some women with what seems a similar situation to mine have chemo (I’m not). Maybe there are still trials going on around the country, or maybe I’m just missing something in their messages!
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