Five months after completion surgery for a Stage 11 ductal/lobular carcinoma, I have just been diagnosed with an agressive contralateral carcinoma (Bloom-Richardson 9/9, HR negative, HER-2/NEU positive, T2 at least, NX,MX). I also have just completed proton radiation for a primary bone cancer and conventional radiation for the original breast cancer(75 Gys proton and 50 Gys photon/electron). With regard to other history, I had a TAH with BSO last year for a Stage 1 endometrial cancer (so four primaries in less than two years).
Medically, I could opt for either a mastectomy or breast conservation surgery. However,in making this decision, I have two questions regarding possible effects of radiation if I were to chose a WLE. Given that I will be having very aggresive chemo either way, would I be likely to tolerate having an additional 50 Gys or so of radiation? Would it be too much radiation? Also, since I will surely have Adriamycin, should the possibility of radiation to the heart (this is the left breast)factor into my decision as well?
Thank you for your help.