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Had mastectomy and lymph node removal, do I still need radiotherapy?
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Had mastectomy and lymph node removal, do I still need radiotherapy?

I have Stage 3B breast cancer, T4, N0, M0. I first had a lumpectomy 3 weeks ago, diagnosis was Invasive Lobular Carcinoma, T4a (tumor infiltrates chest wall muscle). Resected margins were clear. ER postitive and c-erb B2 positive. I am now on Armidex.
Last week I had surgery to remove my axilliary lymph nodes and mastectomy of my left breast. The pathology report showed no residual tumor in my breast and no metastasis in any of my lymph nodes. My oncologist recommended that I undergo radiotherapy since I am T4a. However, my surgeon had mentioned he excised part of my chest wall muscle during the 1st surgery, and felt he had removed all of the primary tumor. Is it still necessary for me to undergo radiotherapy, especially since my lymph nodes and margins were clear?
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4 Comments Post a Comment
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492898_tn?1222247198
That is such a difficult question to answer, as I really think nobody would truly know the answer to it. I am afraid it comes down to your having to decide.
But has you have received two different opinions it would also be reasonable to get a third one? I think that is what I would do, visit another?.

Radiation is not very painful and it's a few minutes every day usually for a few weeks?

I am thinking that since you have already gone through all this treatment, you may as well finish it off completely, and do the Radiation?

On the other hand you are getting up there in age and you may not want to  subject yourself to more treatment, as ....I don't know.

Wish I could be more helpful,

Katrin
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962875_tn?1314213636
Hi,

You did not say how large the tumor was, but since it had already infiltrated the chest wall, and since you are c-erb+ (also known as HER2+), which tends to be a very aggressive type of cancer,  equally aggressive treatment is recommended.

In most cases, this means chemotherapy and Herceptin. (Did your oncologist suggest this course of treatment? Or perhaps they are  omitting it because of your age?)

In any case, I would side with your oncologist and Katrina, to at least do the radiation, if , other than the breast cancer, you are in relatively good health for your age.

Best wishes...
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Avatar_f_tn
Thank you both so much. My oncologist did not recommend chemotherapy because of my age. He also said Herceptin is commonly administered together with chemo, hence he is not recommending Herceptin for me either.

I think I will eventually do the radiation, just worried about side effects, especially at my age and having gone thru 2 surgeries.
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962875_tn?1314213636
Herceptin can be given alone and can reduce the chance of HER2+cancer coming back by 50% and the woman's risk of dying by 40%, but it is very expensive and can bring with it it unpleasand and sometimes serious side effects. I can understand the decison to avoid it and  chemo at your stage of life.

Radiation is usually tolerated well. Although it, too, can come with side effects, most of them are quite tolerable. (There can also be some serious ones,  but the radiation oncologist takes every precaution to avoid them.)

Whatever you decide, I wish you all the best!

bluebutterfly
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