Concern about radiation therapy

Female, 69, 1997 I was diagnosed with invasive ductal carcinoma, grade 11/111, stage 2 as 2 lymph nodes were positive, 22 lymph nodes removed.  Received 4 treatments of adrimycin and cytoxan and 33 radiation treatments to the breast but not under the arm. ...
July 2008 again diagnosed with same type of cancer but determined to be a second primary.Found 1 lymph node/negative. Currently receiving chemo, taxitere and cytoxan.  They would like to have me take 25 radiation treatments to chest and under arm.  I am extremely concerned about the skin reaction and tightening of skin near the arm.  I also have vitiligo on the chest and under the arm.  It was also there 10 years ago when radiated but it is more extensive now.

I am truly afraid of what radiation will do to the skin.  However, they are concerned about recurrence as my Onco DX Type test came back 30.  Want to radiate the margins as one is a little narrow and the lymph straws.

How much will radiation really help control the cancer is the percentage large enough to put myself through it?

[PaulMD]

Hi there.

I believe that recommending radiation treatment for someone with a high Oncotype DX score is still controversial and I don't think the radiation will make such an impact just based on the recurrence score.  Chemotherapy would have more impact in terms of preventing recurrence based on the oncotype score.  I believe they are recommending radiation based more on the fact that they have narrow margins of resection.

If you are really hesitant about radiation, then you may want to discuss with your doctors regarding having another surgery to take out more margins, or to go for a mastectomy if all you had before was a lumpectomy.  If there is nothing that the surgeons can do about the margins, then I believe it is in your best interest to have the radiation done.

Regards.