Lumpectomy without radiation vs Mastectomy

May I ask why Tamoxifen and not an aromatase inhibitor? We’re the same age and I thought Tamoxifen was usually for those who are not yet post-menopausal. I had a mastectomy after two lumpectomies because my surgeon couldn’t get clean margins. I hope all goes well for you.

I can not take the other hormone therapy drugs because I have osteoporosis and those drugs cause bone loss.

I am 65, diagnosed with ILC 6mm. For me Tamoxifen is they choice therapy too due to the osteopenia. Lumpectomy, no Mastectomy and possibly no Radiation.

I was diagnosed at age 70 with a 3 mm size tomorrow, all removed with biopsy but had lumpectomy. Clear margins, no nodes involved. I have osteopenia and taking arimidex for at least 5 years but also taking fosamax to help prevent excessive bone loss from arimidex. Arimidex because I am post menopausal. Fosamax for 2 years then reassess as both AI and Fosamax give joint pain. Just starting otc turmeric for joint pain. No chemotherapy needed and chose no radiation.

When can women with early-stage breast cancer skip radiation after lumpectomy?
September 15, 2022
By Maureen Salamon, Executive Editor, Harvard Women's Health Watch

I'd check out this article as 2022 research findings indicate some women with early stage breast cancer can skip radiation after a lumpectomy. Radiation has latent effects, for sure. I know as I have radiation pulmonary fibrosis. I did not have a lumpectomy but a mastectomy as my cancer was aggressive and I had extra capsular extension. I tried to copy/past URL but couldn't get it to work. Perhaps, you've found by now similar articles. Good luck! Elle

Thank you so much, Elle, for sharing this article. I am familiar with this article and have found several other studies that support foregoing radiation after lumpectomy for women older than 65. And my surgeon said he is going to a breast cancer conference in Miami and that this will be one of the main topics at the conference.

This is of immediate interest to me. I'm having a lumpectomy this week. The cancer is rare, and fast moving. My oncologist gave me 6-18 months to live. The surgeon is more optimistic. So--radiation? I have serious co-morbities: progressing kidney disease, diabetes, early heart disease, and an impaired pulmony function among them. The tumor is in my left breast, over my functional lung (the right one is scarred and partially destroyed from an infection decades ago).
Initially I just thought I'd treat the cancer (neuroendocrine tumor in breast, grade 3, HER, cancer in lymph. I've been told Stage 2 and Stage 3 from different consults.) in a low key fashion and enjoy life as long as I can. I'm on an A-I--no problems. So--question--do I have the life expectancy to make 6 weeks of radiation and the risks worthwhile? If I don't, I can probably go to the Grand Canyon with the time. Of course I and my family will consult with a radiation oncologist. But maybe you all have insights or advice?

@mir123, are you seeing a NETs specialist?

Hello @mir123

I'm glad that you posted again. Since you are currently dealing with NETs, I would suggest, as @colleenyoung did, that you at least consult with a NET specialist. Here is a link, from the Carcinoid Cancer Foundation, that will give you a list of NET specialists around the world.

If there is not one in your area, you might consider a virtual appointment. Will you post again and let me know how you are doing?

I saw one at University of New Mexico. There was a consult with Mayo (via my oncologist), too. Both emphasize "this is treated like ordinary breast cancer." To me, this is difficult to understand, but it is the rule. The NETs specialist said my tumor was too fast moving for NET drugs. My GP would like me to go to U of Utah for a specialist but frankly I doubt there is another opinion. It is very frustrating b/c there are very few stats or outcomes upon which to base a decision. I had a lumpectomy on Thursday and mercifully am healing nicely but my oncologist sees this as palliative rather than curative (prevents breast ulceration but does not extend life.) To be honest the only way I can manage is to accept that I have a poor prognosis, rely on my family, friends, and spiritual beliefs, and attempt some quality of life. Also to do only treatments that I can tolerate (as opposed to chemo). I expect a trajectory to palliative care and then hospice. Advice welcome!