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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@m3rt welcome to connect, I am glad you are here. The study provided above does talk about some new studies, mostly still in specific cases.
You stated that you are both hormone positive. So I would guess this is not overly cautious. Onco dx is a great test but it isn’t the only thing that can determine the best course of action. I think your doctor would like to reduce your risk of recurrence as much as possible.
If I had to choose between radiation and chemo, I would take radiation all day long, I have some experience with both.
Do you have specific concerns about radiation? Did your doctor mention taking endocrine therapy to reduce hormones?

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@auntieoakley

@m3rt welcome to connect, I am glad you are here. The study provided above does talk about some new studies, mostly still in specific cases.
You stated that you are both hormone positive. So I would guess this is not overly cautious. Onco dx is a great test but it isn’t the only thing that can determine the best course of action. I think your doctor would like to reduce your risk of recurrence as much as possible.
If I had to choose between radiation and chemo, I would take radiation all day long, I have some experience with both.
Do you have specific concerns about radiation? Did your doctor mention taking endocrine therapy to reduce hormones?

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No just taking a pill called anastrozole for at least 5 years

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@auntieoakley

@m3rt welcome to connect, I am glad you are here. The study provided above does talk about some new studies, mostly still in specific cases.
You stated that you are both hormone positive. So I would guess this is not overly cautious. Onco dx is a great test but it isn’t the only thing that can determine the best course of action. I think your doctor would like to reduce your risk of recurrence as much as possible.
If I had to choose between radiation and chemo, I would take radiation all day long, I have some experience with both.
Do you have specific concerns about radiation? Did your doctor mention taking endocrine therapy to reduce hormones?

Jump to this post

My concerns with radiation is the possibility of it causing more health issues to the lungs and bones. Thank goodness the chemo was not recommended.

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@m3rt

My concerns with radiation is the possibility of it causing more health issues to the lungs and bones. Thank goodness the chemo was not recommended.

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Anastrozole is endocrine therapy, to prevent hormones from feeding your cancer.
If I were concerned about the radiation, I would talk to my radiation oncologist about this, but I can tell you radiation has come a long way in a short time. They can truly pinpoint a small area now, the risk of lung or bone damage is much less than years past. Also being on the right works in your favor.
Will you come back and tell me what you decide after seeing the doctor?

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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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This is a very interesting article, thank you for sharing it with me. I’m 61, I feel I should do radiation therapy just not sure about the 4-5 weeks. The doctors are talking about 16 days whole breast and 5 days target where the tumor was. I’m just concerned about about the damage from the radiation later down the road.

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The trend in radiation for breast cancers caught that early has evolved a lot. I had a similar situation, with a very small lesion caught early, and negative sentinel lymph node.
The radiation recommended, as an option to consider, was five sessions, each two days apart at Cleveland Clinic. I know that other cancer centers are looking at very short-term radiation as well. [While I was figuring out my decision, I read of a woman who had a similar situation and went to Mayo Clinic and had five sessions of radiation also over a 10-day period of time so I think that that's going to be a general trend.]

One limiting factor will be if the radiation facility has the state of the art technology and people trained to use it. One thing I've learned from a cancer journey is that some recommendations that are made may not be the best state of the art protocol but are the best that a facility can offer at that time and dependent upon the age or quality of its technology. That is one serious argument for going to a top-ranked well-endowed facility that can provide the best current options. I'm always inclined to get a second opinion but any medical decision that is essentially irreversible because that tilts the risk reward balance a lot in my opinion.

For what it's worth, I did have the OncotypeDX test done at the recommendation of my oncologist. It was very reassuring in my case and I'm glad that I did it because it provides more data than just that upon which a chemo decision is made.

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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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My radiologist said that for 5 days small local radiation you need to meet several criterial:
1. age 50 and older
2. tumor ER+
3. tumor size 2cm or less
4. negative lymph nodes
5.margin less then 3mm
6. IDC (ILC ok too)

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@callalloo

The trend in radiation for breast cancers caught that early has evolved a lot. I had a similar situation, with a very small lesion caught early, and negative sentinel lymph node.
The radiation recommended, as an option to consider, was five sessions, each two days apart at Cleveland Clinic. I know that other cancer centers are looking at very short-term radiation as well. [While I was figuring out my decision, I read of a woman who had a similar situation and went to Mayo Clinic and had five sessions of radiation also over a 10-day period of time so I think that that's going to be a general trend.]

One limiting factor will be if the radiation facility has the state of the art technology and people trained to use it. One thing I've learned from a cancer journey is that some recommendations that are made may not be the best state of the art protocol but are the best that a facility can offer at that time and dependent upon the age or quality of its technology. That is one serious argument for going to a top-ranked well-endowed facility that can provide the best current options. I'm always inclined to get a second opinion but any medical decision that is essentially irreversible because that tilts the risk reward balance a lot in my opinion.

For what it's worth, I did have the OncotypeDX test done at the recommendation of my oncologist. It was very reassuring in my case and I'm glad that I did it because it provides more data than just that upon which a chemo decision is made.

Jump to this post

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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