Hello again Skylark,
Yes all this info can get confusing.
Just a note on the Predict Calculator, (I see the new one gives us odds on surviving 15 years and has bishphosphonate treatment factored in). Bear in mind, Predict is concerned with treatments and effects on breast cancer survival rates and not recurrence rates.
i don't know about you but I find percentages are only useful when you have the full info. When they quote "20%" without rads, then it depends if they are talking about 20% of people with your tumour type and characteristics. However, if they are just quoting for 20% of all women who have lumpectomies (I am assuming you have had lumpectomy) then it is possible your odds could be lower due to the tumour characteristics you have stated.
So it all depends on who this 20% is!! Maybe that is something you could clarify with whoever gave you this information. If you are not comfortable or clear with the reasons for radio and how it may specifically affect you, then ask for a second consultation.
Radiotherapy is almost always recommended with lumpectomy. I think this is one of the reasons that has brought it to the same level as mastectomy treatment in terms of recurrence etc. For what is it worth, if I had had a lumpectomy then I would have just accepted radiotherapy as part of the package.
I was originally due to have lumpectomy after chemo but, to cut a long story short, ended up having a mastectomy instead. There was no evidence of vascular or node involvement before or after chemo. There was no tumour left after chemo (i.e. total pathological response to the chemo) and there were very clear margins. As there was chemo beforehand, the true original tumour size could not be determined so they had to go off assumed sizes from previous mammograms and utlrasound which varied greatly!
When Onco (Radiology) recommended Radiotherapy as well, I thought they had got me mixed up with someone else!! I delayed radio and asked for a second opinion. I was told 40% chance of recurrence without radio and 6% with. However, this 40% figure was generalised and not individualised for my particular scenario. It seemed ridiculous considering I had chemo with total response, surgery, on herceptin and anastrazole, and after all that they were telling me 40%!!
One of my main concerns was lung damage. When you have issues already, a possible 10% loss of lung function is a significant amount. My breathing had also been affected by other treatments and had gone downhill since starting chemo. I was also fed up with having treatment to be honest as already before having radio, it had nearly been a year since my first breast clinic visit. There was also the fact that should I get a local recurrence, I would not be able to have radiotherapy again if it is in the same place. I felt in a scared if I do and scared if I don't positon. The scared if I don't won!!
Regards and best wishes to you X
