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Radiation after single mastectomy (SMX): What were your after effects?
Stage 2 --clear margins for IDC after surgery number 1 (1 positive lymph node ..5 clear, 6 removed during surgery). DCIS was at the margins of 1st surgery, re-excision still had positive margins. Conceding to SMX (sad about it) and possible direct to implant. I'm opting out of radiation to breast but since I had lymph node involvement, considering radiation to lymph nodes to reduce reoccurence spread. Onco said will reduce from 10% to 5% but 10% chance of lymphademea ..ugh. Also, showed me area of radiation for lymph nodes and will still hit top portion of breast (want to avoid bc of implant), collar bone and near my heart. Hard choice but curious if anyone else only did lymph nodes and your experience with radiation after effects.
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Something to consider - latest research is saying a functioning lymph system can be effective in fighting cancer. Will the level of suggested radiation shut down the functioning of those nodes? Or probably a better question, can they tell you the risk that it will damage the nodes so they don’t function (what is their research telling them?)
The numbers the doctors usually share with us are what is the risk of cancer recurrence, or risk of lymphedema (you have those numbers). What I’d hope they could tell you is - what is the risk of cancer recurrence or metastasis when radiation to the lymph nodes has damaged functioning VS what is the risk of cancer recurrence or metastasis when lymph nodes are still functioning after radiation.
I would hope they would have that information. If not, it’s time they go figure it out. With AI support they are able to sift through thousands of details captured in research and parse out this type of critical data.
Then it’s a decision about which facility and where has the best outcomes for not damaging lymph nodes to the point of loss of function if you decide that radiation is part of the answer.
With five of six lymph nodes clear, I would also suggest weighing the type of cancer cells you have/had as part of your decision about radiation. My DCIS had cribriform, papilloma, and solid cell formation. It was the solid formation that I was afraid of. The histology of the cancer says a lot about the aggressiveness of those cells.
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1 ReactionI'm not the same as your case but I wanted to commend you for asking these hard questions rather than rushing in. What does your doctor say about 1 out of 6 nodes being positive? Is s/he confident that the other nodes that were not sampled would be negative or at least a high probability of being clear? I have mixed emotions about losing my lymph nodes, but I had no choice. I had several positive cancer nodes turn up upon surgical removal (axillary dissection), and also did radiation to the area because I had extranodal extension. Things I would consider include your age and how aggressive your cancer is (Grade 1, 2 or 3). On the plus side, I can tell you that 3 months out of extensive rads (60 gy), my lymph node count has bounced back to the same level it was post surgery and I am over 60. IMO, if you are fit, normal weight, exercise, and younger, you will have a very low risk of lymphedema doing rads to the axilla. I think surgical removal is the bigger risk.
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1 Reaction@olderbreastcancer Did you get radiation all over-collar bone, neck, etc? Not even sure what is normal for extent of area.
@triciaot Thanks—good point. I get infections easy and lymph nodes in neck has saved me more than a few times. I’m hopeful we can just do near surgical area to pick of pieces and leave the rest alone.
@billiemoore Yes, I did all of the regional nodes - Supraclavicular, intramammary and axilla, plus chest wall. My cancer was occult in ways, the scans did not show the extent of disease. Therefore, I was willing to go aggressive on the rads from the standpoint of my cancer seems to hide. So far, my lymphocyte count appears slightly depressed by the surgery but not by the rads. I’m hoping to get the count up a little more.