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Topic: Radiation...do it or not

Forum: Stage I Breast Cancer — Meet other members with a Stage I breast cancer diagnosis to share information and support.

Posted on: Nov 17, 2020 09:47PM

ValerieI wrote:

In July I went for annual mammogram. A lump was discovered, flash forward I was told I have DCIS. October 6th I had a lumpectomy with lymphnods. Pathology says the tumor was completely removed, no signs of further cancer, markers are ok.

Now for radiation..My appt with radiologist oncologist is this Monday. I will have to travel 70miles each way, through a mountain pass Monday-friday for 4-6 weeks. I'm primary cars taker for my mom who has dementia and there is a 20% copay for treatments which are 10minutes. I'm stressing that leaving my mom alone 3hours a day and the low risk for reoccurring. They already started me on cancer drug.

Any opinions? Any questions I should ask the radiologist? Am I stressing for wrong reasons? Im not looking for "what would you do" , but credible information from those who have gone through treatment who can share thoughts of how they made the decision to proceed

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Nov 17, 2020 10:02PM moth wrote:

You should ask what percent benefit the RO expects from the radiation treatment.
There is a radiation benefit for breast cancer calculator but the site seems down for me right now https://www.tuftsmedicalcenter.org/ibtr/

You can also ask if you qualify for something which is sometimes called the Canadian protocol - it's radiation for fewer treatments.

Radiation appts are very quick in & out but radiation is a powerful treatment.

I take weekends off

Initial dx at 50. Seriously?? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." blog: Never Tell Me the Odds

Dx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC) Surgery 12/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 2/14/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole-breast: Breast Dx 2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/18/2020 Taxol (paclitaxel) Immunotherapy 3/19/2020 Tecentriq (atezolizumab) Chemotherapy 11/26/2020 Abraxane (albumin-bound or nab-paclitaxel) Dx 12/9/2020, IDC, Right, Stage IV, metastasized to lungs, Grade 3, ER+/PR-, HER2- (IHC) Radiation Therapy 12/9/2020 External Hormonal Therapy 12/16/2020 Femara (letrozole) Dx 1/28/2021, IDC, Left, Stage IV, metastasized to bone Radiation Therapy 3/3/2021 External: Bone
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Nov 17, 2020 10:44PM Cowgirl13 wrote:

Definitely ask about the Canadian protocol which is about 19 rounds. I had it and it was very easy.

Be the kind of woman that when your feet hit the floor each morning the Devil says: 'Oh crap! She's up! Dx 5/28/2009, IDC, Left, 2cm, Stage IIA, Grade 3, 0/4 nodes, ER+/PR+, HER2+ Surgery 6/17/2009 Chemotherapy 8/3/2009 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 12/21/2009 Hormonal Therapy 2/23/2010 Arimidex (anastrozole)
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Nov 18, 2020 07:35AM Beesie wrote:

Valerie, did you have a needle biopsy first that provided the DCIS diagnosis? Do you have the pathology report from the biopsy? And do you have the pathology report from the surgery?

DCIS doesn't usually form as a palpable lump - that only happens in about 10% of cases - and usually lymph nodes are not removed when someone has a lumpectomy for DCIS.

DCIS is also always Stage 0 and not Stage I, and you are posting in the Stage I forum so I'm guessing you may have been told that you are Stage I.

Are you certain that you did not have some invasive ductal carcinoma (IDC) along with the DCIS? The two are often found together, but when that happens, the diagnosis is IDC, not DCIS, because IDC is the more serious condition.

As for radiation, if you have pure Stage 0 DCIS, and it is only a small amount and it is low grade, and you have good surgical margins (all things that are on the surgical pathology report) you might be able to skip rads with relatively low risk. But if your DCIS is high grade or if the surgical margins are small, then you would face a significant risk of recurrence if you passed on radiation.

If your diagnosis is in fact Stage I invasive cancer, it is much riskier to skip rads. Here again, if you have only a tiny IDC (not likely if you had a palpable lump) and it's grade 1 and you had wide surgical margins, then your recurrence risk without radiation might be acceptable to you. But with any other pathology, your recurrence risk could be quite high.

So, in terms of questions, first, you need to get your pathology reports, or talk to your surgeon or Radiation Oncologist or Medical Oncologist, so that you are clear about your diagnosis, the type of cancer, size of the cancer, the grade of the cancer, and the surgical margins. With this information, the RO or MO should be able to provide you with an estimate of your recurrence risk, both without radiation and if you have radiation. Then you can decide if the recurrence risk without radiation is something you can live with. If it's not, then the Canadian radiation protocol might be a good option for you.



Dx 9/15/2005 Right, 7cm+, DCIS-Mi, Stage IA, Gr 3, 0/3 nodes, ER+/PR- ** Dx 01/16/2019 Left, 8mm, IDC, Stage IA, Gr 2, 0/3 nodes, ER+/PR-, HER2- (FISH) ** Surgery 11/30/2005 MX Right, 03/06/2019 MX Left ** Hormonal Therapy 05/2019 Letrozole

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