Breast cancer radiation after 70? What options have you considered?

Posted by beazerholt45 @beazerholt45, Nov 9, 2021

What options have you considered? No radiation – arimidex only? Is partial breast radiation an option.
ACS states women over 70 e certain breast ca characteristics may consider no radiation. Your experience in making a decision to skip radiation for anti-estrogen to only..

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I would consider my quality of life short vs long term with whatever treatments the doctor is recommending, of course I am assuming you trust in your doctor. There are different types of radiation. Targeted radiation is less treatments which is nice. If you have to go to radiation 5 days a week for a few weeks, would this be a hardship for you? Also radiation can leave you feeling very fatigued, but keep in mind this is temporary. There are thousands of women on endocrine therapy with no side effects or minor side effects. There are of course the possibility of stronger side effects. There are threads full of those conversations from that minority of women who have trouble. Those troubles are real, they are also a small percentage of the people taking them. Can you share more information about what they are offering as choices? Also do you know what your onco dx score is?

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I have agreed to Arimidex
After BCS my tumor is stage 1
1.1 cm, clear margins and Neg Nodes.
I did not expect to be offered only traditional Full breast radiation option
Radiologist want decision by Next Monday for charting
Oncotype dx results due next Friday.
Should I wait?
Is there a firm rule about rad 4-6 weeks after surgery?

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@beazerholt45

I have agreed to Arimidex
After BCS my tumor is stage 1
1.1 cm, clear margins and Neg Nodes.
I did not expect to be offered only traditional Full breast radiation option
Radiologist want decision by Next Monday for charting
Oncotype dx results due next Friday.
Should I wait?
Is there a firm rule about rad 4-6 weeks after surgery?

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Have you looked at the Tufts University test that shows the recurrence rate in the same breast with and without radiation and hormone therapy? https://www.tuftsmedicalcenter.org/ibtr/ Hypo-fractionated radiation is often recommended for patients with early stage breast cancer. It is just 16 sessions without boost. As for timeline, it is my understanding that radiation should start no later than 12 weeks from surgery, while 6 weeks is optimal.
The oncotype dx test results will let you know your distant recurrence risk with hormone therapy. Radiation is a local therapy that lessens local recurrence and potential future surgery that might entail mastectomy. It is considered optional for women over 70 yrs old with early stage cancer and no nodal involvement because it does not affect mortality rates given the low aggressiveness of cancer at older age and the possible co-morbidities of older patients.

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I just turned 80. I finished 6 weeks of radiation at the end of August. I had a lumpectomy and chemo first. I had involvement with 2 lymph nodes. .I decided to not do hormonal treatment because i tried and it makes me feel emotionally unhappy. But, the radiation, other than having to go every day, was easy. I got some nipple soreness and redness on my breast, but I didn't suffer any fatigue from it.

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@beazerholt45

I have agreed to Arimidex
After BCS my tumor is stage 1
1.1 cm, clear margins and Neg Nodes.
I did not expect to be offered only traditional Full breast radiation option
Radiologist want decision by Next Monday for charting
Oncotype dx results due next Friday.
Should I wait?
Is there a firm rule about rad 4-6 weeks after surgery?

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Radiation should ideally start at 6 weeks but I did find this study on breastcancer.org that says under 8 weeks.
https://www.breastcancer.org/research-news/delaying-rads-after-dcis-incr-recur-risk
Would you be comfortable asking you doctor what the considerations are for only offering full breast radiation, ie; cancer grade, type of cancer, risk of recurrence with or without radiation? If partial breast or targeted radiation is available to you, or available in your area?

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@auntieoakley

Radiation should ideally start at 6 weeks but I did find this study on breastcancer.org that says under 8 weeks.
https://www.breastcancer.org/research-news/delaying-rads-after-dcis-incr-recur-risk
Would you be comfortable asking you doctor what the considerations are for only offering full breast radiation, ie; cancer grade, type of cancer, risk of recurrence with or without radiation? If partial breast or targeted radiation is available to you, or available in your area?

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Another point of consideration in making the decision and timing is that the OncotypeDX test score will indicate whether chemotherapy is advisable for the early stage ER+Her2- invasive breast cancer. Chemo is ususally given before radiation. My MO waited for my score before referring me to the radiology oncologist. It would seem understandable that you would want that test score before scheduling radiation therapy.

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@raebaby

I just turned 80. I finished 6 weeks of radiation at the end of August. I had a lumpectomy and chemo first. I had involvement with 2 lymph nodes. .I decided to not do hormonal treatment because i tried and it makes me feel emotionally unhappy. But, the radiation, other than having to go every day, was easy. I got some nipple soreness and redness on my breast, but I didn't suffer any fatigue from it.

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I am 81 had bilateral lumpectomy over 3 months. Because I have heart
arrhythmia, after discussing the treatments with surgeon and onco- doctor I settled for Tamoxifen only, assuming chemo and/or radiation would worsened my AFIB-heart arrhythmia.
I think Onco Dx test would ease my worries, but I couldn’t convince the doctor to do
He says I don’t need it , because I don’t have chemo.
Having tamoxifen only for a month , I don’t have significant side effects YET . Perhaps, it come with the time.
Anxiety and fatigued yes, but I believe is due to my age.
I still in the dilemma if I should have radiation done before starting Tamoxifen.
Maybe Onco Dx test would give me an answer! !
How to convince the drs ???
Is anybody with heart problem have similar treatment approach?
Thank you

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I don't have a heart problem so I can't answer that one. I'd go for the radiation, though I've read it doesn't have a real significant affect on the cancer not coming back. We are so old, I am kind of betting on it not coming back again in my lifetime and not taking the taxmoxifen because I can't stand feeling so emotionally upset. As i mentioned, I had no problems with radiation except having to go every day. However, other than the cancer, I had very good health.

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I saw the oncologist today and he said i can discontinue my anti-hormone as i became so emotionally miserable on it. He looked at my hormone levels and said they are fine. He told me to avoid soy products.

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When and How the doctors checks the hormone level.
Thank you

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@raebaby

I saw the oncologist today and he said i can discontinue my anti-hormone as i became so emotionally miserable on it. He looked at my hormone levels and said they are fine. He told me to avoid soy products.

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I am really glad he said go ahead and quit. Just an FYI, black cohosh Is also very high in estrogens. I am so happy for you.

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@monigue

When and How the doctors checks the hormone level.
Thank you

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It’s a blood test

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