1. < Breast Cancer
Profile picture for Lynn

Radiation 5 vs 15 fractions

Posted by Lynn @lynnmarie406, Sep 2 2:56pm

Hi all 🌻

I just got my surgery’s pathology report and it’s all great! The chemo had killed all of my HER2+++ tumor and nothing in the nodes!! Yay. 🎉
But, along with the lumpectomy/lift I received, comes the bonus prize of ✨radiation. ✨
I had a phone consultation with radiation today and was told they have changed protocol and would like to give me 5 days at a high dose (26 gray in 5 fractions= 5.2gy per day) It was previously discussed back in May that I would be receiving a 15 day treatment (40 gray in 15 fractions=2.67gy/day) Even though the total amount is more for the 15 day, the daily radiation is doubled for the 5 day plan.
The nurse who called me said, the result and side effects are the same, if not better on side effects. But I am reading up on it and this 5 day plan is relatively new, having been accepted in Europe in oct 2020 and some of the US clinics in 2021.
Where I am receiving treatment, at Md Anderson near Houston, I was told radiation oncology “recently change their protocol” to offer this option.
Now my question, has anyone had this 5 day regimen?? Do you, or your doctors, think that the long term side effects are more or less than the traditional 15 day regiment would’ve been?
I guess I mostly worried that receiving a such higher doses of radiation would be more harmful than receiving multiple smaller doses. I did read that the higher doses do cause more fibrosis and hardening of the breast tissue and the breast skin than the lower daily dosage would. I’m also worried that the stronger radiation would affect your heart and lungs.
I’m seriously considering, requesting the 15 day regimen. The convenience of five days doesn’t really draw me in. I live like 15 minutes from the cancer center and going every day wouldn’t bother me.
What are your thoughts on this?
Thanks so much😊

Interested in more discussions like this? Go to the Breast Cancer Support Group.

Profile picture for kathyoung
kathyoung | @kathyoung | Sep 3 11:07pm

I had stage 1 with no lymph node involvement, I had a lumpectomy followed by 5 radiation treatments. I was very worried about burning, however, I didn’t have any problem at all. I was diligent about applying the cream the radiologist recommended, applying it before, and after treatment plus two or three times a day during the treatment, also before going to bed.
Hope this helps. You have to do whatever you are most comfortable with, good luck!

REPLY
Profile picture for wyowyld
wyowyld | @wyowyld | Sep 4 5:30am

It was targeted radiation however I did use a fairly large piece of film. I believe most five day radiation is targeted, but could be wrong.

REPLY
Profile picture for marshgirl24
marshgirl24 | @marshgirl24 | Sep 4 7:56am
In reply to @health77 "I finished 30 days of radiation on August 14th. It was not difficult at all and..." + (show)
Profile picture for health77 @health77

I finished 30 days of radiation on August 14th. It was not difficult at all and my skin did not get as cooked as the shorter type of radiation. The only problem I had was keeping my arms above my head for 10-12 minutes. I am 77 and I consider the care I got to be excellent!

Jump to this post

Yes, that arm pose is difficult. Did you hold onto a metal bar? I asked about the prone position. One of my friends had that. But my facility did not offer it and I never, ever want to be the first one they try something on!

REPLY
Profile picture for marshgirl24
marshgirl24 | @marshgirl24 | Sep 4 8:01am
In reply to @triciaot "@lynnmarie406 I did the 5 days of radiation at MDA in 2022. I had 30g, 600..." + (show)
Profile picture for Rubyslippers @triciaot

@lynnmarie406 I did the 5 days of radiation at MDA in 2022. I had 30g, 600 gy each day, every day. I believe they are now scheduling it for every other day.
I did not have any skin issues. Now 3 years later, I do have some skin thickening where the radiation touched - it does not feeel different to me but I did have a last plastic surgery adjustment to that breast in November 2024 and the breast is taking longer to drop into place, but the skin feels okay.

I also have some internal scar, most likely radiation necrosis. It doesn’t change the shape of the breast, the breast is soft, but a lumpiness can be felt in that area. I would guess lots of people have this - but I don’t know.
I’d make the same decision again. Private message me if you want to talk! I’m in the Austin area.

Jump to this post

@triciaot That is so interesting. I didn't know that the skin thickening could appear later. I'll have to look up radiation necrosis. Yes, my breast has remained soft. I'm on anastrozole so I suppose with time they will droop a bit more. That doesn't matter to me. I'm in my late 70s and happy to be here! My breast MRI last week was good and that's the main thing. I'm fine with things the way they are.

REPLY
Profile picture for marshgirl24
marshgirl24 | @marshgirl24 | Sep 4 8:08am
In reply to @lynnmarie406 "That you everyone for the replies. It’s very reassuring to read everyone else’s experiences with the..." + (show)
Profile picture for Lynn @lynnmarie406

That you everyone for the replies. It’s very reassuring to read everyone else’s experiences with the radiation. 💖
@pbnew The fibrosis I am worried about is with all the scar tissue and the rearranged tissue from surgery. I had a 3.5cm long, flattened and killed from the chemo, invasive ductal tumor that went right up to under the nipple. The surgeon removed that, clean margins, and then the plastic surgeon rearranged the remaining tissues and did a lift, removing a lot of extra skin. Did the same in the other side to make it match. 👍🏻. Also, because of the location of the tumor, my relocated nipple had nothing under it, so to speak. Like the surgeon literally just reattached it, hoping that the nipple would not die, like a skin graft. Luckily for me, the skin didn’t die, 😅 it is still very tender and discolored though.
What I am thinking is maybe with all this newly healing and rearranged tissue, that the shorted stronger radiation might cause more outer skin and internal breast “damage” than the 15 day lighter radiation. But do the extra days of lighter radiation equate to the same possible damage ?? I really need to have a proper talk with the radiation oncologist.
My radiation is for the full breast, and I will be lying flat on my back, with my arms above my head. I will need to hold my breath for 25-30 seconds. I’ve started practicing for that.

Jump to this post

Good luck to you with your treatment! The first day of my radiation (last December) I felt like such a failure because the breathing was hard for me. But I went home and found a video on breathing during radiation. A male doctor had produced it. It was very helpful. I think I practiced for thirty minutes or so. The ladies couldn't believe it the next day when I showed up and kicked that needle right up there (and hold). We are Warrior Women and we will succeed! But it is one day, one breath at a time.

REPLY
1 reply
Profile picture for Miriam, Volunteer Mentor
Mentor
Miriam, Volunteer Mentor | @mir123 | Sep 4 9:06am
In reply to @marshgirl24 "Good luck to you with your treatment! The first day of my radiation (last December) I..." + (show)
Profile picture for marshgirl24 @marshgirl24

Good luck to you with your treatment! The first day of my radiation (last December) I felt like such a failure because the breathing was hard for me. But I went home and found a video on breathing during radiation. A male doctor had produced it. It was very helpful. I think I practiced for thirty minutes or so. The ladies couldn't believe it the next day when I showed up and kicked that needle right up there (and hold). We are Warrior Women and we will succeed! But it is one day, one breath at a time.

Jump to this post

A great idea to practice!

REPLY
Profile picture for vlaugtug
vlaugtug | @vlaugtug | Sep 4 9:49am

I will be meeting with my radiation oncologist tomorrow. it will be interesting what she advises. My question to you, is are you having proton beam radiation? My cancer is left breast and I am VERY concerned about heart lung issues. the proton beam is supposed to protect surrounding soft tissue exposure, but we shall see. She felt she could protect my heart ALMOST 100%, which, of course, is not 100%. this is my main concern. The breath hold method is one used with the Photon machine, which it sounds like you are having, and that helps to pull the heart out of the field. I did a lot of research on this. but I can assure you that your radiation oncologist at MD Anderson has seen your exact excision hundreds of times and she will have your answers. I am going to the Mayo in Minnesota and all of my research does not add up to a drop in the bucket compared to their education, research and experience. Through this whole process I have gone through I have had to remind myself..they know better..hrummmph..can you imagine that?

REPLY
Profile picture for ruffianfan55
ruffianfan55 | @ruffianfan55 | Sep 4 10:59am

I had an even shorter course of radiation, 3 treatments, delivered over 2 days via brachytherapy. I can’t say that it was a “picnic in the park”, but I am glad that I chose it over external beam. My horribly bruised, swollen breast is almost back to normal after a month and a half. My cancer was very close to the nipple and on the left side. I was worried about my heart, but brachytherapy is very targeted to the tumor bed. The skin of my areola is a lot darker, but it’s peeling now, so I expect that it will be better soon, I wouldn’t hesitate to get the shorter course, but you need to do what you’re comfortable with, as everyone has said. Hope that whatever you choose is “easy peasy” and effective! Best wishes and hugs!💚

REPLY
Profile picture for mimig77
mimig77 | @mimig77 | Sep 4 2:43pm
In reply to @marshgirl24 "When I was first diagnosed a year ago (lobular stage 1b) i was at first told..." + (show)
Profile picture for marshgirl24 @marshgirl24

When I was first diagnosed a year ago (lobular stage 1b) i was at first told one week of radiation. But because it was lobular, they decided to do 15 treatments over three weeks. I’m sorry but I don’t know the dosage. But i had no problems with it. No skin problems. No fibrosis. It was right breast so heart was not involved. Had a breast MRI last week and everything is still good.

Jump to this post

Same-ILC stage 1, radiation likely to start next week for 15 treatments. It’s reassuring to read of your experience. I have had no problems with Anastrozole, thank goodness!

REPLY
Profile picture for sue417
sue417 | @sue417 | Sep 7 8:18am

Hi
I I had the 10-day radiation double dose opposed to 4 weeks not had anything like that before I didn't know what to expect I was fine my breast didn't burn my skin was okay I just used the cream they told me to use but the fatigue was brutal 3 weeks after for one year my last radiation treatment was April 2nd 2024 and I just recently have started to feel more like myself which now is September 2025 I wish you luck

REPLY
View MoreView Less
Please sign in or register to post a reply.