Right breast cancer DCIS: Is 4-5 weeks of radiation normal protocol?

Posted by m3rt @m3rt, Feb 21, 2023

I recently was diagnosed with (DCIS) stage 1, her2 negative, both hormones positive, 4mm size tumor. I chose to have a lumpectomy and do hormone treatment. The doctor removed 4 lymph nodes in the breast and one sentinel node all were negative for cancer. The tumor was removed January 23, the doctors said because the lump was so small they didn’t do a onco. test, but suggested that I do 4-5 weeks of radiation. I was wondering if 4-5 weeks for radiation is being over cautious? Or is this normal procedure? I will be laying on my back for radiation treatment.

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@windyshores

I just read this article about radiation for older women. Don't know your age!

https://www.statnews.com/2023/02/15/older-breast-cancer-patients-study-radiation-survival-rates/

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Just want to make sure to say that I posted the study on radiation for older women because it was interesting, but I made no comment at all and it is up to everyone to read it and understand that there are lots of studies with lots of conclusions that I and we are not qualified to assess 🙂 In no way was I posting that in order to guide anyone's decisions, and concluding anything from that study would be premature unless your doc uses it!

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@simba2022

I had right breast dcis.
Stage 0 since still in the ducts. Hormone positive. They didn't do lymph nodes since they knew it was contained. I did lumpectomy, and they still had me do 3 weeks of radiation lying on my back. Now on anastrozole

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Hi, thank you, with the 3 weeks was it whole breast or was some of that time targeted and if so how many days? Do you know the radiation strength they gave you? How long ago was your surgery?

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@windyshores

Just want to make sure to say that I posted the study on radiation for older women because it was interesting, but I made no comment at all and it is up to everyone to read it and understand that there are lots of studies with lots of conclusions that I and we are not qualified to assess 🙂 In no way was I posting that in order to guide anyone's decisions, and concluding anything from that study would be premature unless your doc uses it!

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Totally understand, it’s very interesting How breast cancer is treated in different areas. And I suppose that some of it is due to the equipment age the doctors have to work with. So far this blog and all that has responded has really made me feel more comfortable! The more we read and research gives us a chance to ask better questions with the doctors and understand.

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@m3rt

Hi, thank you, with the 3 weeks was it whole breast or was some of that time targeted and if so how many days? Do you know the radiation strength they gave you? How long ago was your surgery?

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It was whole breast. 3 weeks 5 days a week. I had surgery late March 2022. Radiation started early April 2022. Not sure what the strength was.

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@m3rt

Hi, thank you, with the 3 weeks was it whole breast or was some of that time targeted and if so how many days? Do you know the radiation strength they gave you? How long ago was your surgery?

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Dosage 4005 cgy in 15 fractions if that makes sense

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@m3rt

Wow, this information makes me wonder if I should travel to Cleveland or Mayo for the 10 day treatment or how it compares to the treatment that I’m being offered? Any idea what the strength of radiation for the 10 day was?

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I don't know the details of the 5-day radiation dosage or however radiation is described. But, again, I read an article online by a woman who was offered the same short course of radiation at Mayo Clinic. And I'm sure there are other facilities that have the technology and training as well.

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I'm posting this article included in today's ASCO email as it specifically refers to radiation in older women after breast-sparing cancer surgery. I don't think that's the same radiation that was offered me though. But the old rule of thumb was that the choice was either mastectomy or lumpectomy plus radiation. And I think that it's still strongly recommended for younger women for whom almost any kind of breast cancer tends to be much more aggressive.

PRIME II Trial: Breast-Conserving Surgery With or Without Radiotherapy in Early Breast Cancer

https://ascopost.com/news/february-2023/prime-ii-trial-breast-conserving-surgery-with-or-without-radiotherapy-in-early-breast-cancer/?utm_source=TAP%2DEN%2D022223&utm_medium=email&utm_term=4cf962011c9ee11a42cbb2ed9ce1807f
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@callalloo

I'm posting this article included in today's ASCO email as it specifically refers to radiation in older women after breast-sparing cancer surgery. I don't think that's the same radiation that was offered me though. But the old rule of thumb was that the choice was either mastectomy or lumpectomy plus radiation. And I think that it's still strongly recommended for younger women for whom almost any kind of breast cancer tends to be much more aggressive.

PRIME II Trial: Breast-Conserving Surgery With or Without Radiotherapy in Early Breast Cancer

https://ascopost.com/news/february-2023/prime-ii-trial-breast-conserving-surgery-with-or-without-radiotherapy-in-early-breast-cancer/?utm_source=TAP%2DEN%2D022223&utm_medium=email&utm_term=4cf962011c9ee11a42cbb2ed9ce1807f

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@callalloo I posted this study elsewhere though the focus was on the fact that radiation for those >65 made no difference in terms of metastasis or overall survival. The focus here seems to be more on the increased risk of local recurrence, without radiation. In either case I posted again that noone should make treatment decisions based on this study, without consulting a doctor.

Here is an excerpt: The investigators concluded, “Omission of radiotherapy was associated with an increased incidence of local recurrence but had no detrimental effect on distant recurrence as the first event or overall survival among [patients] 65 years of age or older with low-risk, hormone receptor–positive early breast cancer.”

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I'm 81 and had 6 weeks of radiation every day when I was 79 after a lumpectomy and chemo in my right breast.. I have had no problems from it. I get a mammogram every 6 months to a year and so far so good. I don't take estrogen inhibitors because I already have weak bones and hate the way they make me feel . I live alone on 22 wild acres in the CA mountains (beautiful snow today) and I can't drive, but my kids still help me enough and the local cancer society pays to get me to my medical appointments with a Ride-On service. The only problem I would say was that when my port for chemo was removed it had been in the same right breast and it took longer to heal than normal. I think that was from the radiation to my skin. Now I can barely see where it was.

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@windyshores

@callalloo I posted this study elsewhere though the focus was on the fact that radiation for those >65 made no difference in terms of metastasis or overall survival. The focus here seems to be more on the increased risk of local recurrence, without radiation. In either case I posted again that noone should make treatment decisions based on this study, without consulting a doctor.

Here is an excerpt: The investigators concluded, “Omission of radiotherapy was associated with an increased incidence of local recurrence but had no detrimental effect on distant recurrence as the first event or overall survival among [patients] 65 years of age or older with low-risk, hormone receptor–positive early breast cancer.”

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I certainly agree that no one should make any decisions based on just a study. Studies of human health are really complicated because it's impossible to isolate only one variable and hold all others identical when dealing with human beings. So there's a lot of 'noise in the system' as a statistician would call it when dealing with human beings yet alone human health. The best advice is still to try to find the experts in the field and get at least two or more opinions from them and then think it through and make what feels like the smartest decision at the time.

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