Radiation and Tamoxifen together

[merk]

I am  a  50 yo w/ DSIC grade 3 2cm in size- I am otherwise healthy. The DCIS was 3+ for both estrogen and progesterone. I still menstrate regularly.  I had a lumpectomy with clean margins.  Based on recommendations of the cancer team I had a bilateral breast reduction(with additional excision of lumpectomy site)  one week after the lumpectomy.  It was felt that I would do better with radiation if my breasts were smaller.  I would then take 20mg of tamoxifen following radiation. The pathology from the reduction showed 2 small foci of LIN- grade 2 and 3 , no more cancer. I now have a failed skin flap on the cancer breast with an open wound.  The surgeon concidered a skin graft but the team decided to let it heal on its own.  I had the lumpectomy 10 weeks ago and anticipate at least another month for this to heal.  My first question is how long is safe to wait until starting radiation and does the wound need to be completely healed? I was told that it did not need to be totally healed. Second, yesterday the radation oncologist told me to start the tamoxifen now and not wait. Is there any harm in starting the tamoxifen prior to the radiation treatments- it seems everyone recommends starting after radiation. thanks so much for your help

[CCF-RN,MSN-rf]

Dear merk:  The time to start radiation therapy will depend upon the opinions of the surgeon and the radiation oncologist, who can see and evaluate the tissue.  Tamoxifen can be taken safely during radiation.  Your oncologist should make this recommendation for you.