Hello!
Just wondering why some women have radiotherapy when they have a mastectomy and others don’t? I’m seeing my oncologist tomorrow to start the ball rolling on the radiotherapy side of things - but my surgeon seemed quite surprised that I was having radiotherapy. I know the oncologist knows best…and I will be asking why at my appointment tomorrow. I was just wondering what your experiences are?
Thank you!
x
Hiya,
I had radiotherapy purely because I had traces of cancer in my sentinel node biopsy and I also had lymphovascular invasion. If I didn’t have these things, I probably would have not had rads. Saying that though, I think it depends on your consultant and hospital.
Paula x
Sandytones
I had Neo-adjuvant chemo, then Mx. My results for chemo showed very little trace of cancer but I still had a full Mx and full node clearance and am having 3 weeks of Rads.I wondered myself why but my team want to make sure there is no trace left at all,
At the end of the day I want the best treatment for my circumstances so I accept their plan.
Jean.
Hi
I had mx, immediate LD flap recon, 15 nodes removed, chemo and rads. Nodes were all clear and, in my case, they recommended rads because the tumour was close to the chest wall - there was a clear margin but only 1.7mm!
Dx
I was told that the decision whether or not to have rads after mx depended on how many lymph nodes turned out to be affected (when they operated). Less than 4, no rads… more than 4, rads… I had 10/18, so had chemo and rads… Jane
Hello Sandytoes,
I think there are several reasons why rads may be offered post Mx e.g. tumour close to chest wall or where 4 or more nodes are involved especially if there is a higher risk of reoccurrence. My Onc advised there is growing evidence that rads are beneficial where less than 4 nodes are involved, especially with high grade cancers. There is an ongoing trial called the Supremo trial giving rads to women who have less than 4 nodes involved. I mentioned the trial to my Onc and he offered rads to me outside of the trial(I had Mx with immediate recon. I’m Grade 3,stage 2B (40mm IDC), OE positive and HER2 positive, 2 nodes involved).
regards,
Bobtail
I was told I didn’t need rads after my mx + chemotherapy. The onc said tgey looked at 3 criteria- number of nodes (4or more then rads needed); size of tumor (5cm+ needed rads); and margins (if tumor close to chest wall then rads needed). I didn’t meet any of these criteria + so was told no need for rads as risk of local recurrence was minimal. Guess what? It recurred locally within a month of my last chemo!!
I would say if rads is an option then take it just to be sure, especially if the lump was big-ish +/ nodes involved.
Good luck x
I had a clear SNB, MX with immediate LD recon, chemo for microinvasion in large area of DCIS and was told I’d need radiotherapy because of a close margin next to the chest wall.
DJ007 how did you find the rads on the recon? I should be starting mine next month.
xxx
Hello Sandytoes
I posted a reply a little while ago but it seems to have gone off into a black hole so I’m trying again. I am 43 and was diagnosed with Grade 3, stage 2B (40mm IDC), OE positive, Her2 positive, 2 nodes involved. I have had Mx with immediate LD recon, 3Fec + 3Tax plus herceptin so far. Will start Zoladex this week. My Onc advised there is growing evidence that rads are beneficial for cases where there are less than 4 nodes involved but a higher risk of reoccurrence. There is an ongoing trial for this called the Supremo Trial and I meet the criteria. I have been offered rads outside the trial and I am going ahead as I want to give myself every chance of beating this.
regards,
Bobtail
Hi Cherrytom
My rads finished 5 weeks ago. I didn’t have any skin probs - just the expected pinkness/sunburn effect. They did tighten everything up again - I’ve had to make sure that I reinstated the exercises that I’d started to get a bit slack on.
Too early to tell if the rads will cause any shrinkage (I think that’s less likely with muscle flaps than tummy flaps), or if I end up with capsulation round the implant that needs to be sorted at a later date.
Good luck
Dx
Thanks, DJ007 xxx
My consultant said immediately after diagnosis that the treatment plan would be neo-adjuvant chemo, mx with anc and rads due size of tumour and node involvement but most of all due to my age and wanting to treat the cancer very aggressively. Rads would have happened after mastectomy with any level of node involvement but the difference being whether you had rads to the axilla (if 4 or more affected). X
Young age is increasingly a reason to have rads alone, regardless of anything else. Only way to make sure the skin and chest wall have been treated, and young age is an independent risk factor for recurrence sadly.
I had breast conserving surgery, so needed rads anyway, but was told that I would have needed it after a mastectomy anyway due to my tumour touching the chest wall.
The grade and size of tumour are also factors in deciding whether radiotherapy is needed. Vascular invasion, lymph invasion, close margins, number of nodes involved, position, age, fatty invasion, incomplete clearance of breast tissue, and of course whether the patients choose to have it or not.
Cackles xxxxx
Hello all (Sandytoes, sorry its me again!)
I was advised by my Oncologist that I would be having radiotherapy due to my tumour being attached/close to the chest wall and also that there were cancer cells present in the blood vessels in the surrounding area. He explained that they were taking this approach as a “mop up” after chemo, as although my sentinel node result was clear his preferred approach was to give me everything they’ve got 
My mum had radio as well, although hers was quite gruelling as she underwent chemo at the same time as part of a trial. However she’s been really reassuring around this as she says the side effects are not as severe as chemo. I also am in contact with a lady I met in treatment who’s just started and she says that although she’s a bit tired its actually ok.
Embo xx
I was told from the start because I was going to have neo-adjuvant chemotherapy (ie chemo before surgery), I would have to have rads.