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Radiation or not
Hi,
I’m 77 and had a lumpectomy for invasive ductal carcinoma. ER+, Her2-, 1.4cm.
Oncologist said radiation and tamoxifen,
Tamoxifen because I have mild osteoporosis and it’s less damaging to the bones. She also said that it was reasonable for me to skip RT.
The radiologist said with radiation the chance of recurrence would be 1-2%, without radiation it would be 10%. She also said it would be okay to skip radiation because the overall survival rate is the same, with or without radiation. Has anyone had to make that choice? I would love some input. Thanks.
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@nancyk71 Intraoperative radiation is not nearly as effective as external beam radiation. When you look at the recurrence data from the major IORT trials, the recurrence rates are very similar to the non-treatment arm on studies evaluating omission of radiation in low-risk disease. There is also the risk of still requiring external beam radiation when you have the IORT which is before the final pathology is resulted.
@brooklyn22 yes, it's sometimes referred to as FAST-Forward Therapy & everything I read says it's as effective as longer treatments for early-stage breast cancer. I did "whole-breast" (some people only target the tumor area) because my ILC doesn't grow in a lump, it's more diffused. Overall, it's a wonderful option! 😊
@saraheja
I'm not sure where you are getting your information.
There is, I agree, the risk of still needing some external beam radiation if the cancer is likely to have already spread (e.g., no clear margins or extensive lymph-node involvement), but the information that I have found says in early stage breast cancer IORT is just as effective as external radiation, and safer for the heart and lungs. I didn't want to attach 1 million websites and studies here, so here is simply one summary from the surgical breast care group at Columbia University, who presumably know the research so far…
https://columbiasurgery.org/conditions-and-treatments/intraoperative-radiation-therapy-breast-cancer
I grappled with the same decision after I had a lumpectomy 2 years ago for IDC. I decided to have Accelerated Partial radiation which is targeted directly to the area of the tumor, not the entire breast. It was only 5 treatments and I had absolutely no side effects. There appears to be some fibrosis now as a result but I don't find it bothersome.
@nancyk71 I am a board-certified Radiation Oncologist who trained at Mayo Clinic Rochester and practices at Mayo Clinic Arizona. My information comes from the peer reviewed breast cancer literature, mainly prospective trials, and can be summarized in this statement from our leading professional society (ASTRO).
https://www.astro.org/news-and-publications/news-and-media-center/news-releases/2025/astro-corrects-media-misinformation-on-breast-cancer-treatment-options