Anyone over 65 with early stage breast cancer omit radiation

I fit the criteria of this Harvard study-
“ women 65 or older who have small tumors with nonaggressive cells that haven't spread to the lymph nodes. Medically, this is described as a T1N0, grade 1-2 tumor. The tumors must be estrogen receptor-positive, meaning that the hormone estrogen helps fuel their growth. They also must have an adequate margin of normal tissue surrounding the tumor cut away to ensure all the cancer has been removed. Women who decide to omit radiation instead receive medication known as endocrine therapy for five years. This stops cancer cells from using hormones like estrogen to grow and spread.”

But to omit radiation they recommend hormone therapy - and there are many women who stop hormone therapy before the recommended 5 years. If deciding to not have radiation, I would take a good look at the type of side effects many women have, and the effects that it has on other organs throughout your life before deciding. It takes a commitment to stay on the hormone therapy to match the benefits of the Harvard study.

I’m not discouraging it. I am on tamoxifen, but I did choose to not take an AI which was also recommended to me. I had an option of either. And, also, there are women who don’t have side effects, but the majority do. I wish they could better determine who might/not have side effects prior to taking the med!!

Factors I used when considering to have radiation (5 days only), was: intermediate grade 2 score, cancer history in extended family, 1 mm margin on a small focal point (I chose to not have another surgery for this), and because I had a fine needle biopsy which some research says has a very small risk of releasing cancerous cells into the breast. It had been thought in the past that any of those cells would not be pushed into an area of the breast that would support cancer growth, but I believe the new research is discussing the breast cell environment as more critical to supporting cancer. With my 100% ER+, 95% PR+ cancer, my edge of obesity fat level (fat is where the estrogen hangs out), and my now obvious ability to grow cancer - it seemed like a great cell environment to grow more! Covering that area with radiation to kill any wayward cells was my hope.

What if your surgeon recommends: 5 weeks/5 days a week radiation and endocrine therapy for early-stage 1A/early grade 2, no nodes, clean margins by 3mm, under 2cm tumor, over 65? If it were only one or the other, that would be fine, but not the whole kitchen sink

@flygirl747 You may get a better answer from someone who has A1. Mine was stage 0 DCIS. Your pathology report may give you more detailed info about why they are recommending both. A1 is usually non comedo type (that’s good!), but if there was more solid type pattern to the cells, versus cribriform, papillary, or other, may be of higher concern.

Do you have a choice to see a radiation oncologist? She could give you a fuller explanation or more choices . Do you have an Oncotype dx score? It is used to predict recurrence and usefulness of radiation. Ask for one to be done..just google it for more info.
Best luck. JAS