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Decision: Should I Do Radiation?

I had my first visit with the radiation oncologist yesterday and he’s leaving it up to me to decide if I want to undergo radiation. He said that there’s no data to show that I would receive anything but a slight benefit, and the risks would be small, so it’s a toss-up (but of course he would recommend it because he believes in the technology as a provider of it!). I had a double mastectomy with no reconstruction for invasive ductal carcinoma, Stage 2A, with 1/14 lymph node involvement, but the weird thing is that the one lymph node had no living cancer cells at biopsy and upon dissection—my own immune system killed off all the cancer cells in my node. The radiation oncologist said that this is extremely rare in breast cancer. Since I’m retired, the 5 weeks of daily radiation is no big deal, and it’s my right side that would receive treatment, so there’s no potential impact to my heart. And since there’s no no reconstruction, there’s no worries about impacting that. However, my lung could be affected, and I may have to increase my thyroid medication due to potential impact to my thyroid. He said that micro-cells may remain in the chest area lymph nodes that can only be reached by radiation. I’m surprised that chemo (6 rounds of TC) wouldn’t kill those off. Any thoughts from all my supportive new friends on this site?

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I would do it! It really is not bad at all. Really like a bad sunburn. Use the aquafer and creams they give you. I had 7 weeks. It really didn't even make me tired too much. Each week progresses and is a little more intense. I had the right side as well and basically maybe had a slight scratchy throats but that may have been due to fire smoke from forest fires around area. Try any thing to stop this this in it's tracks! I would rather this than chemo. 🙏

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I just had 6 rounds of chemo and surgery is going to be on nov 14th. Then I am supposed to start radiation on dec 1st for six weeks. I have tank choice to do it

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Sharon1014, what do you mean by “tank choice to do it”? Autocorrect working its magic?

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I meant I have no choice to do it.

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Good luck to you Sharon!

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Here’s an update — First, thanks to those who responded. More responses would be much appreciated. I read through threads from other breast cancer support group sites where scare stories abound about the long term side effects that the doctors never tell you about or acknowledge when confronted with them. Most of these are from women who had lumpectomies and are upset about the impact on their remaining breasts, or who had mastectomies with reconstruction and upset about the impact on their implants. That wouldn’t be me because I’m remaining flat Others upset with the side effects are suffering through painful nerve damage to the surgical site, and a couple of women ended up with sarcoma at the scar, which even they acknowledge is extremely rare. Of course, a few people said they had no problems whatsoever, and most people who who would respond to a thread are those who did have problems and wish to share their stories. I think I’m leaning towards having it done. A couple of studies on older (which I am), node negative, hormone positive women who had lumpectomies showed a slight improvement in risk of recurrence if they had the radiation. Since I’m node positive, even though it was one that was entirely necrotic, I’m thinking that I ought to play it safe. The cancer DID travel to the node, which scares me, and the doctor said, which I confirmed in my research, that tumors found in the medial portion of the breast (somewhere below the nipple) would tend to travel to the nodes that he intends to radiate, the mammary and supraclavicular nodes. Thanks again to those who responded.

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Glad you did decide. You get tired of recovery after surgery and I would imagine much more after chemo. I did not have to do that as they did that Onka test on me and it was low so I did not have to do the chemo. the radiation was really pretty simple. I know different for everyone but just to ease your mind some. Now I am on Tamoxifen- just started that. Good Luck too you🍀

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Tinydancer1 I think you are making the right decision. Even with just 1 necrotic lymph node involved its better to be safe. You are opting not to have any reconstructive surgery so you shouldn’t have much problems after the radiation. I opted for Hypofractionated Radiation which was a little more radiation and less visits. So I had 15 day whole breast and 3 day tumor site. You may get red but fortunately for you won’t have to wear a bra that’s a plus😁 Just find some really soft tops to wear during treatment that will help with the sensitivity of your skin on that side. Please let us know when you get started with Radiation and keep us updated on your progress. Good luck to you my dear🙏

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I have about 5-6 different colors of the Amoena Valletta camisole tops with the breast form pockets. They are the softest fabric ever and I know I’ll be living in them during the “sunburn.” I highly recommend them — they’re expensive, but you can find them on sale through different vendors if you search online periodically.

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Good to know!!! Let us know how the Treatments go😊

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I don't know a lot about this. I'm gonna have radiation after my surgery. But I guess if there's any chance any cancer cells are left it's worth it to have the radiation. Good luck and let us know what you decide.

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Hi Tiny Dancer, Glad to hear you've made a decision. The worse part of going through breast cancer is the decisionmaking! Good luck with the radiation. Everyone responds differently, but I'm very fair-skinned and got through it with the equivalent of a sunburn.

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When I was initially diagnosed with bc, it was invasive and before the bone mets were found during initial staging, the preliminary plan was to have chemo to shrink the primary tumor, then a lumpectomy, followed by radiation. I was okay with that plan. Then mets were identified and everything changed. It's now over 13 years later, and I've had a lumpectomy and hormonal treatment and bone meds and am doing well, though I will be in treatment forever and at 71 am tired. If my onc recommended radiation, I would do it. If my onc recommended a mastectomy, I would push for a double, and would not do reconstruction. At least that is what I think, lol. Can never know for sure what we'd do in a hypothetical situation. I hope that whatever you do, you will have peace of mind about it. Something you might consider doing is writing a letter to your future self about why you are choosing the route you take, so if you second guess yourself later, you can reassure yourself that you did the best you could at the time with what was known then. Whatever we do, we could have done something different!

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Thanks! I made my appointment for the initial CT and mapping to be done 3 weeks after my last chemo infusion, which will be about Thanksgiving time. I used the future me technique on my grandson who wasn’t putting any effort into his schoolwork! I never thought of using it on myself! Hope you continue to do well,PJBinMi, and try to do some physical activity, even just walking, to reduce the tiredness. It works!

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I would do it. It is not to bad. Make sure to use the moisturizer that they give and it make make you a little tired but just know the last week and maybe the week after that is the hardest and it was surprisingly easy. I had 7 weeks and a boost! Good Luck🍀. I think it is all in the mind set too. Keep hydrated☺️

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