Lumpectomy with radiation vs mastectomy for stage 1 invasive plus DCIS

I had 2B invasive ductal. negative nodes.
Had a lumpectomy
Bilaterally.
Post Op infection so have to wait to heal then 5 radiation
Waiting. For results if onoctype & generic results then ER inhibitor, bone density& then Zomex IV every 2 months

You would still need tamofoxin
Skip the radiation with mastectomies
They prefer skin saving lumpectomies
More surgeries if u choose reconstruction

Six weeks ago, I--a 77 year old woman with moderate COPD--was diagnosed with stage 1b IDC and underwent a mastectomy of my left breast. The pathology results reported clean edges, but out of four lymph nodes removed, traces of cancer was detected in two of them. The doctors' game plan includes undergoing five weeks of daily radiation. I have put the brakes on the radiation until I find out, based on my pathology, the percentage of potential risks versus the benefits of radiation for someone of my health and age. I also am asking them, the risk of recurrence if I don't do the radiation. And conversely what is the benefit in risk reduction if I opt for adjuvant radiation? They have agreed to present my case at their weekly meeting where they do such things. I'm stunned this isn't standard procedure. Oh, by the way, the cancer cells have been described as "slow growing" and my Oncotype score was "0".

I recently had bilateral lumpectomy surgery and will be starting radiation within a week or so. My radiologist gave me a prescription for a cortisone cream that I will apply twice a day to the breast and continue for two weeks after completion of radiation. It hurts my heart to read about my sisters who are receiving no info re this issue or incomplete info. It makes sense to me that the cortisone will give me at least some level of comfort. I will let you know how well it works. Name - Mometasone Furoate 0.1% cream (Mometasone)

I agree it was the radiologist nurse that insisted on the sulfadioxide cream to help me to get through radiation it helped in Two days to allow me to complete my 32 treatments looks perfect now no scar

Can you share the radiation side effects your mom had to deal with?

May I ask what side is involved. I had left side and radiation. Later had heart disease. Of course, I don't know if Ca was the cause--just throwing it out there. Very best wishes to you.

They really don't know for sure if you'll need radiation until AFTER the pathology comes back from the mastectomy. I was told no radiation or chemo necessary (but anaprazole, yes - a tamoxifen alternative) before I had my left mastectomy. After the surgery, they reported finding cancer in 1 of 3 nodes removed during the mastectomy, so radiation was recommended (but fortunately, no chemo.) I was told I could skip radiation, and still have good odds of the cancer not returning, but my odds were slightly better with the radiation. I'm a big fan of the best odds possible, so I opted for radiation. I'm now about 2 weeks in and so far it's pretty easy. Started the anaprazole this week. No regrets at this point! Good luck with everything.

I had a course of radiation at 76, with no continuing issues, once I had recovered from the fatigue. Still on Anastrozole, which I am finding reasonably tolerable. But the effects of chemo - peripheral neuropathy- are permanent.

I wrote a really long response, which won't post. Basically, as a 78 year old b.c. survivor, I am so glad that I went through with the 33 radiation treatments, because I definitely cannot and could not tolerate the adjuvant therapy pills (and I tried for over a year). Taking Anastrozole for 7 months caused my already fragile left knee to blow out and put me in a wheelchair for 6 months (September, 2022 - March, 2023), I didn't get an oncotype after surgery because I had a horrible oncologist (Illinois), but I finally got it 17 months late and it is 29, which is not a good score and means I should probably have had chemo. Taking Anastrozole for 7 months and Tamoxifen for 5 months ruined my left knee (I had been in a nationwide study called the MOST study for severe osteoarthritis, so he should not have prescribed the A.I. pills.). It also caused my bone density to decline from -1.4T to -2.2T (I am also a Type II diabetic). Two of my teeth sheared off below the gumline and the dental work started in November of 2023 and took until May 9, 2024 and cost $10,000. (My Illinois oncologist, of course, has denied that any of this was the result of the Anastrozole and said, in writing, "The only side effect of taking Anastrozole is a little bit of stiffness in your hands when you wake up first thing in the morning, and it goes away when you quit taking it." (Complete B.S.) Among the side effects I experienced on Anastrozole: EXCRUCIATING back and joint pain, Insomnia. Blurry vision. Mood swings. Teariness. Brain fog. Vivid violent nightmares, and then my left knee---already fragile from a bicycle accident) ---blew out as I was walking along a Chicago sidewalk to meet a girlfriend for lunch. X-rays on 9/19; 9/21; 9/28 and 11/15 in Texas. The pain caused me to drive to a joint pain clinic in Oak Brook, Illinois and have 32 ml of an anti-inflammatory injected and 6 ml of Durolane. I spent from September 15, 2022 until March of 2023 hobbling with a cane and in a wheelchair and my left knee will never be "right" again. On Tamoxifen, I experienced extreme fatigue and could only be up for 3 hours a day. Also, I had non-stop UTIs and now my liver enzymes are messed up and I had blood drawn for the 3rd time this morning to try to figure out why. (Also had to have a CAT scan with contrast.) Just remember that every drug has the possibility of side effects and there are a % of people (like me) who just cannot tolerate them---any of them. I should have been prescribed Tamoxifen, but that was no day at the beach, either, and if I had a 0 oncotype (instead of the 29 that says I have a 36% chance of recurrence) I would not take ANY of the adjuvant therapy drugs they prescribed. I do realize that everyone is quite different and you may have no bad side effects, but, for me, I'm just grateful that I went ahead with the radiation, because, 3 days before it was to start, Iowa City told me that they would not have radiated me at all, but that is really all that is hopefully "protecting" me now. I just cannot live the rest of my life (I'm heading into my 8th decade soon) sitting in a wheelchair in excruciating pain on the off chance that the pill that is making me miserable will "protect" me. If I have to resume taking one of the toxic pills to reduce estrogen and "protect" me, I will try Tamoxifen in a reduced dosage again, because I could just barely tolerate 40 mg a week (10 every other day), but my oncologist said I needed to step it up to 20 mg. a day and that was the beginning of the end. I quit them all on Aug. 30, 2023. I am apprehensive that my relatively high onco score of 29 will lead to a recurrence, and, as my Texas oncologist said, "I'm not worried that it will come back in your breast. I'm worried that it will come back some place else." And so am I, in the light of liver enzymes that, on May 1 were 78 (ALT) when they aren't supposed to be higher than 57 and, 23 days later, had risen to 145. The taking of toxic substances at our advanced ages is NOT the same as if we were in our thirties or our forties. I am really hoping that the radiation protects me, because the pills were godawful.