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Radiation after masectomy


I was diagnosed 8/2023 with 1b stage breast cancer. tumor 2.1 cm now reduced after 5 rounds of chemo to 1.8cm. Had 3 lymph nodes with cancer, after ultrasound now appear normal. Before chemo there was something working in left breast but biopsy was not performed but now gone after chemo. I am estrogen positive, her2positive, gene testing normal and maternal aunt with breast cancer. I am wanting a bilateral masectomy/with reconstruction to not worry of recurrence. I am 57 yrs old. Surgeon is recommending radiation on lymph nodes and both breasts with masectomy or lumpectomy. She is also comfortable with just lumpectomy on right. What is anyones experience with radiation after masectomy??? I have completed 6 rounds of TCHP, continuing with Herception and Perjecta for 12 cycles, wanting bilateral masectomy with no radiation to breasts, not sure on axillary lymph nodes in armpit. Surgeon wants radiation to avoid cancer developing in other parts of body. ANY INFO APPRECIATED.


  • tb90
    tb90 Member Posts: 281

    I had radiation following mastectomy in 2013 but due to positive margins. I had no more difficulties or SE’s than is typical for radiation to the breast and have had no long term effects at all. Radiation prevents local (site of radiation) recurrence but does not prevent distant recurrences. Systemic treatments, such as chemo and tamoxifen are required for that. But if there are cancer cells in nodes, killing those cells would definitely be preventive. All the best!

  • moderators
    moderators Posts: 8,216

    @ecbostwick45, welcome to our community! We're sorry you had to find us for this reason, but glad you did!

    Alongside the valuable insights shared by our community members, our website offers additional information on radiation after mastectomy that could be helpful for you:

    Some Women Benefit From Radiation Therapy After Mastectomy

    Reconstruction With Implant Immediately After Mastectomy Affected More by Radiation

    ASCO Updates Guidelines on Radiation After Mastectomy

    Good luck with your decision! Please, come back to let us know how you're doing!

    The Mods

  • fd1
    fd1 Member Posts: 58

    I had radiation after mastectomy to chest wall, regional nodes, and scar. This was recommended because I was 31 when I was diagnosed. I do believe there have been some studies that show this reduces the risk of distant recurrence also but I can't remember if those were limited to "younger" patients or not.

    My reconstruction is definitely not optimal because of the changes from radiation. I also have radiation skin changes (not visible in a bra but not pleasent to look at personally), and lymphedema in my arm. Was all this worth it? I'll never know but I would do it again. I wanted to throw everything at it that had any scientific reasoning behind it because I was so young. I was stage 2B with two positive nodes and a 2.4 cm tumor.

  • sarahnh
    sarahnh Member Posts: 105

    If pathology shows no live cancer in your nodes after surgery, then you should at least be able to avoid radiation to the nodes. This is based on a big RCT that just reported:

    For radiation decisions, you might want to consult with a radiologist, instead of relying only on your surgeon.