Radiation or not

Posted by gerarda @gerarda, Nov 23, 2022

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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Good to know. Thank you! I am willing to keep going if there is some hope of feeling better.

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Perhaps I am in the minority but I feel like less is more with cancer treatment. The entire endocrine medicine is an absolute no for me even at 64. If I had what I have now and I was 75 I would not treat this at all but do active surveillance. I am onboard with lumpectomy and proton therapy only, they have already said no to chemo so that was good but if they said chemo or endocrine I would do chemo! And if for some odd reason I can't do Proton then I do surgery only.

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@frogjumper

Perhaps I am in the minority but I feel like less is more with cancer treatment. The entire endocrine medicine is an absolute no for me even at 64. If I had what I have now and I was 75 I would not treat this at all but do active surveillance. I am onboard with lumpectomy and proton therapy only, they have already said no to chemo so that was good but if they said chemo or endocrine I would do chemo! And if for some odd reason I can't do Proton then I do surgery only.

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@frogjumper to me "less is more" in cancer treatment also refers to endocrine therapy that allows us to avoid chemo! We don't know your situation: Did you have an Oncotype? How responsive is your cancer to estrogen?

When you wrote you would prefer chemo to endocrine therapy I was surprised! Many of us have few side effects and the meds are supposed to reduce risk by almost half. I was 63 at diagnosis and am almost 72. I miss my letrozole: it made me feel safe.

I wanted to avoid radiation so I had a mastectomy. I suppose proton therapy might feel safer.

Anyway, curious why you are so opposed to hormonal therapy, to the point where you would prefer chemo to an AI! I am sure you have reasons....

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@frogjumper

Perhaps I am in the minority but I feel like less is more with cancer treatment. The entire endocrine medicine is an absolute no for me even at 64. If I had what I have now and I was 75 I would not treat this at all but do active surveillance. I am onboard with lumpectomy and proton therapy only, they have already said no to chemo so that was good but if they said chemo or endocrine I would do chemo! And if for some odd reason I can't do Proton then I do surgery only.

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hello Dear
I think Cancer is a kind of disease that wont give you so many options to be cured , you should leave yourself to your doctor and trust him .. If I had the choices I should never ever do Chemo since its the worst part !! if you havent done that so you have no idea what it is !

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I dont know why your dr said no need for radiation ! because I hears its only side effect is that your skin will be irritated just this !

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I was diagnosed 2 years ago at age 67 with IDC no node involvement- Oncotype was 12. My surgery was partial mastectomy with reconstruction. I had huge margins and grade 1.
My Radiologist advised that I did not need radiation - a second option concurred. My tumor was directly over heart - which gave me a higher risk of heart damage
So, I am taking Tamoxifen now after terrible side effects from AI’s.
My recurrence chance with adjuvant estrogen suppression is ~ 3%
Best wishes to you!

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@yasamin

I dont know why your dr said no need for radiation ! because I hears its only side effect is that your skin will be irritated just this !

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There is also the chance, likely, for lymphadema and fibrosis, from radiation. I have both, and it is terrible.

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@thseabreze

There is also the chance, likely, for lymphadema and fibrosis, from radiation. I have both, and it is terrible.

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I had 16 proton radiation treatments after left mastectomy and 6 nodes removed. I was told by my surgeon and my proton radiation oncologist at the Mayo in MN that I would not have lymphedema. I don't. I did have mild cording in the axilla which PT cured. Had some trigger points in the pectoral muscle connecting to shoulder that were also resolved with 7 sessions of PT. I am positive that proton radiation is the BEST form of treatment.

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I’m 64, had excisional biopsy for dcis on left breast. I decided to not do RT ( same reason as you- little benefit and I’ve been on mega vitamin D since I was 50 for osteopenia.) I’ve also decided to not do hormone blockers. I have so little estrogen as it is, and I still have hot flashes and major depression. Each woman’s situation is different; I am glad my surgeon and oncologist agree with the conservative approach. I am doing follow up imaging in 6 months.

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Definitely on radiation, otherwise reoccurrence in five years is high statistics. And in our 70's is relatively young according to my pharmacist.

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