Hi
This is my first time posting. I went for my routine mammogram last September got recalled back had the usual further tests and was told I had invasive breast cancer Grade 2 ER & PR+.
I had surgery in November a week after my 67th birthday they removed the lump, the margin round and 2 sentinel lymph nodes. At my post op they told me the margins were clear and the lymph nodes negative. I was told I’d need radiotherapy & hormone therapy.
I had an appointment at oncology last week and was told I had the option not to have radiotherapy but had to commit to take the tablets for 5 years. I was given a prescription for Letrozole and told to start taking them.
I was quite overwhelmed as I was not expecting this.
It’s my choice and I’ve got a couple of weeks before I get my planning appointment to decide.
Has anyone else been given this option and what did you decide?
Hi @yorkshirelass1 I was very similar to you in that I was recalled from a routine mammogram just before my 67th birthday, had surgery to remove a S1 G1 er+ pr+ HER2- IDC. Had clear margins, no lymph involvement, no LVI. Unlike you, I was not given a choice but my rads programme was changed from 15 to 5 days unexpectedly. I was also given Letrozole for 5 years at my first oncology appointment. I happily went along to radiotherapy, found it easy and had no serious skin breakdown or side effects other than fatigue a month or so afterwards. I’m well over two years past it now and haven’t had any issues. For balance, not everyone is as comfortable as I was to have radiotherapy for a variety of reasons, some of which can be found in threads on the Radiotherapy subcategory. Adjuvant endocrine treatment such as Letrozole has the potential to cause significant side effects, such as menopausal symptoms, bone thinning and cognitive impairment - once again, not for everyone and even if you were to experience SE there are methods to deal with them and alternative drugs to try. But it is a big commitment to agree to five years without knowing how the drugs will affect you. If you were to decline radiotherapy but found that you could not tolerate Letrozole, then you would be in an exposed situation. Other people will have alternative views but I don’t regret having had rads at all and it has given me options with regard to managing Letrozole side effects. Good luck with whatever you decide to do.
This was my logic - take radiotherapy (due to start shortly) and also go on endocrine treatment. However “should” I not be able to tolerate the tablets “at least” I have done the radiotherapy. My oncologist said only 40% of women complete the full 5 years on endocrine therapy (please note just repeating what I was told so not sure if researched facts would back this up).
Hi there. I’m 67 and had a lumpectomy three weeks ago. Sentinel node biopsy (4 nodes) were clear.
At my follow up appointment I was offered (‘party bag’ style!) Anastrozole to take for five years. I said I wasn’t keen and so the surgeon ran my details through a prediction programme.
Taking the blockers would give me a one percent benefit over five years and 4% over ten years. I don’t feel it’s worth the side effects so decided not to take them.
Oncology appointment coming up on 28th and hoping I can find more info about the percentage benefits of radiotherapy to help decide on the best way forward.
I had lumpetomy for garde 2 IDC ER/PR+ HER2- in December, clear margins, 5 nodes removed all clear and had my first oncology appointment today. I was expceting to be booking in for radiotherapy and finding out about endocrine therapy.
The radiotherapy has been out on hold awaiting results of genetic testing and endocrine therapy awaiting a gynae referral due to inconclusive menopause status. I thought I was going to be getting answers and a plan today but instead I am plunged back into limboland.
The waiting has to be the worst 
Hi Tigress
It caught me completely off guard I was not expecting to be given the option.
If I decide to go ahead with RT I will only have 5 sessions.
What concerns me most about side effects of Letrozole is the possibility of osteoporosis, however if I don’t have radiotherapy I’ll have to take the tablets for 5 yrs. I’m really considering having radiotherapy. x
Hi, I had same diagnosis as yourself 2 years ago at 63. I decided with my oncologist and predict to go for whole breast radiation just in case the tabs didn’t work for me. I had 5 days radiotherapy and due to other issues started on tamoxifen. SE were horrendous and it has taken me 18 months to almost get back to how I was feeling before I took them. My SEs are slowly dissipating with the help of conventional and alternative medicine. You must do what is right for you ; we are all as unique as our cancers and diagnosis. 
I was told if I had radiotherapy and couldn’t tolerate the tablets there could be a possibility to stop them but right from diagnosis I was told treatment would be surgery, radiotherapy and hormone therapy for 5 years.
I just want to give myself the best chance of it not coming back.
Hi mandyo
I agree waiting is the worst it feels like forever between appointments. Hang on in there.
Hi Shoo
It’s such a difficult decision. I want to give myself the best chance of it not coming back and I was told if I have radiotherapy this time & god forbid it does come back I wouldn’t be able to have radiotherapy again.
I was offered both though my benefit from endocrine was extremely low and I was told that it would be reasonable to stop if I didn’t get on with endocrine. I already had a feeling that I might not manage 5 years of endocrine ( just sounded so damn long !) so it seemed a good idea to have the radio and my Oncologist agreed. I’ve had some problems with fatigue afterwards and a red swollen breast but still far preferable to the side effects I had from Anastrozole which I abandoned after 5 months. Tamoxifen was also not an option for me due to previous medical history. I’ve had fatigue again recently but I’m feeling quite a bit better so I think it was a virus.
Some things you might want to consider ; was your cancer on the left or right ? If it’s on the left it’s very slightly more complicated and I would recommend going through it with your BCN or the BCN on the helpline .
Also : are you the kind of person who is able to commit to taking something for 5 years when you don’t know the side effects . I know I’m not. Not everyone gets the side effects or they find them to be manageable but when your risk is so low that they think you may not need them then the risk / be efit ratio isn’t that clear.
I think you should try to discuss the pros and cons of both with particular reference to you as an I dividual with your history with a sympathetic professional . Radiotherapy is best done within a certain time frame . You could decide to start the tablets a bit later ( or so I’ve been told ) but radiotherapy needs to be done in a certain time frame .
Sorry I think I may have added to your dilemma . Unfortunately in BC world all the decisions are all yours and they’re all scary. If I had to choose again I would probably do exactly the same again. Xx
Radiotherapy is a one time only option @yorkshirelass1 for the same breast. If it was to come back, then it be a mastectomy. If you had a new tumour in your other breast, you could have radiotherapy for that. Arguably, however, you have a better chance of not getting a recurrence by having radiotherapy. It nukes the microscopic cancer cells that get left behind after surgery. The main issue is that the window for effective radiotherapy is quite small so you wouldn’t be able to have it later if you found that you couldn’t tolerate the endocrine treatment. I felt that I wanted to take everything offered to reduce my chances of recurrence and, with chemo off the table (thankfully) that was the familiar trio of surgery, rads and AI but you must do what you feel is right for you.
And for the record it doesn’t sound as though they have handled telling you all this very well . Between 20 and 30% ( not sure if the exact figure ) don’t complete the full course of endocrine therapy which is why they are emphasizing that . Xx
Hi,
How old are you, if you don’t mind? Women after at least 55 may skip RT, but many choose to have it (I read so).
I thought RT has to be done 4-6 weeks after lumpectomy or becomes useless.
Why do you need the genetic result first, do you know?
I am 42, had lumpectomy on Jan-11 and need to urgently decide on RT or completion mastectomy. I am struggling a lot with choosing.
You also need to talk it through with someone. I know people who have waited 10 weeks . I waited 7 a s I was 56 at the time and such a an early low grade tumour that I was put on the SMALL trial and initially randomized for removal of can we u der radiology guidance with just local anaesthetic and no SNB . This failed so I then had the lumpectomy under GA . In order to fulfil the conditions of the trial I was supposed to have 5 radiotherapy treatments but I had a very forward thinking surgeon who would definitely have told me if he thought I could skip radiotherapy . Make sure of your facts and make the decision you can live with . If you don’t feel you can talk to your BCN then maybe the Nurses on the helpline here . It’s really hard as a lay person or even as a medical professional with just some knowledge to make these decisions for yourself but at the same time I personally know that I don’t ever want them making for me I just want to make the right one xx
Hi
I am 55, I am being tested for 7 genes for BC, it was part of a trail but I also have cancer on both family sides. If it comes back positive and I decide to have bilateral masectomy I won’t need the radio. The results should be back soon and as I would only have 5 days radio I am ok to wait.
Good luck with your decision x
Hi
I had lumpectomy for G1, St1 tumour. Took tamoxifen in my case until I’d finished radiotherapy, then stopped the tamoxifen as too many side-effects that I couldn’t live with ( and her 2+ so likely less effective anyway). Glad I did the RT, though younger so not given it as an option ( although any treatment can be declined really). Not offered chemo to consider as low grade.
Hi @linda6
I hope that snippet about radiotherapy 4-6 weeks is inaccurate……I had to wait 14 weeks from my last surgery. There were no complications from surgery, but I did have a temp oncologist that didn’t seem to know what she was doing. I believe (but won’t ever get confirmation) she messed up the referral to Radiology causing the delay.
I did question the timescale, but never got an answer. Hence I “HOPE” your information is wrong 
Dont worry, it’s a bigger window than that. I think it was about 10 weeks till I had it, was told ots not a problem.
Morning all 
Ive been reading this thread and although I’m in a slightly different position it was very informative to read your thoughts so thank you 
I had a lumpectomy in June 2024, no clear margins and 3 of 4 nodes were positive. Chemotherapy was next for 16 treatments in 20 weeks (a lot but goes by quicker than you think) and on 29th of January i had a mastectomy. I’m healing ok but still a few bumps along the way… Radiotherapy is the next step but still to be discuseed on the 26th with the oncologist so for now i have no idea for how long it’s going to be, but i do know that hormonal treatment comes after, but again still to be discussed… has anyone been in similar position?
Also, my little lifts box request was approved and on it’s way 
. The link below if you want to apply x