Anyone had mastectomy & chemo but no rads?
I've had my surgery in Jan this year - right side mastectomy with immediate strattice & tissue expander reconstruction. Onco-plastic surgeon at the time said I was borderline case for having chemo, but no radiation therapy needed. I'm currently half-way through chemo. My understanding re. rads decision is that my tumor was less than 5cm (mine was 2cm), not embedded in chest wall, clear margins & v. low lymph node involvement (1 in 33).
Original surgery & decisions were made in UK, NHS treatment.
I came back home, to Ireland to have chemo with family support.
BUT, now the team dealing with me here say that a 10yr old european study says that there MAY be some benifit to me having radiation therapy.... My UK team and other US studies would disagree, I'm concerned for my strattice which prob won't stand up to rads and won't be replaced like-for-like by HSE (they'll opt for diep etc. because I'm a public patient) and I feel that I've got no concrete reasons to do rads other than fear and a broad sweeping 'just-in-case' approach with rads in Ireland.
Anybody here NOT had rads after mastectomy & why?
Or, anyone given good clear reasons why they did need it and what exactly it would do to benifit your body?
I meet radiation oncologist again this wk and will of course put all these questions in front of them again too 
Hope everyone's treatment & recovery going well xx
Comments
Hi Bettersooon, I am not having rads and was also a border line case for not having chemo after mastectomy as I had multiple small tumours rather than one large mass. Chemo decision was ultimately based on the proven chemo + Herceptin combination,rather than Herceptin alone.
Re radiotherapy, similar to yourself it was not deemed necessary due to tumour size, position, clear margins, no muscle or skin involvement and nodes all clear.
Its difficult to generalise on why it may or may not be necessary and the detail of your own pathology report is what is important.
Best of luck and would be interested to hear how you get on. You've got me thinking !!
Hi better soon, i had chemo first followed by mastectomy. I was told initially that i would have rads but as i had clear sentinel node biopsy and good response to chemo they decided that there would be no benefit to my having radiation. I have Not had any reconstruction yet anyway. I had 3 areas of cancer in my breast,all her2+++. I've just finished my Herceptin and feeling good. As far as i know, once there is any lymph involvement they recommend radiation. Sorry if thats Not what you wanted to hear,but hope it helps.
Hi Bettersoon
I had a mastectomy and immediate strattice reconstruction last October. I had two small tumours and my sentinel node biopsy was clear. I scored low on the oncotype DX test so didn't need chemo and I don't think radiation therapy was ever on the cards for me which was the reason why I was offered a strattice reconstruction.
Best of luck with your treatment.
Maimie
What is a strattice reconstruction? Have Not come across it in my literature, have only just started reading up on some reconstruction methods.
I had a double mastectomy,chemo and no rads.Lobular carcinoma, two tumours in left breast.No lymph node involvement.I did have lymphovascular invasion(That is where it invaded the bloodstream where by the tumours set up their own little lymph and blood supply network!)............So far so good.I was diagnosed 2 yrs in August.
Hi Bettersoon,
How did you get on with the radiation oncologist? I hope all your questions were answered and you are happy with the decisions made about your treatment.
Take care.
Roseo
Hi All & thanks for your responses.
Good news is, decision has been made. No radiation therapy!
I'm really pleased because I now know where the invasive treatments end.
It was a real quandary for me, to feel that I had different decisions coming from two different teams, but I spoke to both nurse specialists (UK & IRE) before meeting the radiation oncologist, and had made my mind up not to have it before the meeting anyhow. And the RO wasn't in opposition, and wasn't able to give me any compelling reasons to do it in my case. Bottom line, they told me, is that in my situation, it may or may not make a small percentage of difference whether or not cancer returns to the same area. And given all factors, it is a reasonable risk not to do radiation. The same wasn't true of chemo, there was a clear benefit to me there.
But thank you! The broad view of how others have been treated helped focus my mind. I wanted to be sure that I was being treated as an individual case and not being treated with broad-sweeping generalisation.
Anyhow! That's another step done and dusted. It's always just one hurdle at a time I start 12 weeks of Taxol in a few days, AC is now behind me (thank f***!)
Ooh, and in response to Lala, the strattice... it's a type of porcine tissue they use in my reconstruction, it was stitched in to create a 'sling' in which to hold my implant, since they removed all breast tissue on my right side. Macmillan Cancer Care were a great source of info for me... here's a whole section on reconstruction, but it varies here from hospital to hospital, and with different surgeons, so check what's available to you
Hi Bettersoon,
I know two women here in France who has mastectomies due to having several small tumours. Neither had lymph involvement. As there was no breast tissue left and no problem with the lymph nodes they had neither chemo or rads. Just went ahead with reconstruction.
There is some variation from country to country, for example here it is very rare to have complete auxilliary clearance. I had 13 removed, 4 were massively invaded and clumping together. With even one bad node in Ireland, they remove them all. As you had one node affected they may want to do rads under your arm. Another argument is if the tumours were close to the skin, the scar area or breast bone and that some residual tumour activity may still exist.
Try to find out what the arguments in favour or doing rads are as well as the risks involved.
Hope this helps.
Kath