To boost or not to boost

And also under 50.

Hi @brighterdays

In 2013, with stage 1 BC, clear lymph nodes, clear margins, BRCA2+ and double mastectomy, they told me no radiation. They told me if I had a lumpectomy, I would need radiation.

In 2020, my BC cancer returned in my chest wall and pectoral muscle. Tumor was removed, but there was a positive margin. Lymph nodes clear. Ki-67 50% this time, very aggressive. They did 37 radiation treatments, 28 regular plus 9 boost all on the side where my chest tumor was, about 8" x 12" area. I tolerated the first 20+ treatments very well (then things got a little rougher), but I think you'll do well with the 15 or 15 + 5. That was 2.5 years ago and I didn't have any lingering effects except drier than usual skin on that side. Calendula cream works great. Use it twice a day from day one even if you don't think you need it. Skin was darker after it healed, but that went away in a few months. Once you start radiation, the appointments are quick and easy. The actual radiation was about 2 minutes each time. Given that my cancer came back, I'd probably lean toward more treatment initially.

Best of luck in your decision and treatment. Blessings, Zebra

Please ask your radiation to explain the treatment plan again because if memory serves me (which it may not 🤣) the course of treatment is to have so many weeks of targeted radiation (I had 3 weeks ) to the tumor bed as that’s why they’re marking the area of your tumor bed and targeting that precise area.

Then I had one week of whole breast radiation which I was told that is the boost. For that week, I did not have to get into position as they were targeting the entire breast.

My treatment was standard protocol for having a lumpectomy. ♥️

I had 16 treatments and then the 5 treatments of the boost for a total of 21. No problems with it. I was 46 at the time; I went to radiation before work and went on with my day.

It was a while ago so radiation protocols have changed drastically since I had mine. 6 weeks plus boost.
I can speak to the fact that you are only 50, meaning you have a lot more years to be happy with or regret the the decisions you make now. I was younger than you and I just took everything I could to stop it.
When it came back, I did not have to ask if I had done all I could do. If I had do to decide on boost or no boost, my decision would clearly be yes boost. Because you can do 5 days standing on your head if it means no recurrence. Lol
Do you have concerns about the radiation boost?

I did not until the second radiation oncologist omitted it from my treatment plan. When I asked her why she said I have clear margins and the boost only decreases risk of LR 2-3% and she didn’t see it as significant. If there was a recurrence she said I could then get a mastectomy. She mentioned increased risk of fibrosis with the boost. But from what I’m reading in regards to guidelines, I fall under the < 0 year old, boost strongly recommended.

I don’t know when you had your treatment but did you have any long term side effects? Why did your doctor suggest the boost?

I had 5 total days of treatment at Mayo, under the Fast Forward program, and the boost was included right along with the regular treatment.

I had my radiation 14 months ago. No lasting effects. The only real side effect I had during treatment was some skin sensitivity, but I used the special cream given to me and that kept discomfort to a minimum. My radiation doctor told me the boost was part of my suggested treatment. I didn’t really question it. The boost required slightly different positioning, but quite frankly, I didn’t notice anything different about it at the time. I viewed it as 21 treatments, and the boost portion was the same as the rest, except where the machine was aimed.

How did the reoccurance get found if you had a mastectomy?