I have Inflammatory Breast Cancer stage 3c, I initially had 6 months of chemo followed by a MR mastectomy on 11 Oct with full axillary lymph node removal. Pathology showed that, despite the 6 months chemo, they removed a 3cm tumour & 23/26 malignant lymph nodes. I have been waiting for radiotherapy to start ever since. I have already started on 3 weekly Herceptin injections plus daily Letrozole tablets.
My question is - how long should I be waiting after mastectomy for radiothetapy to begin? It’s now just over 3 months since I had my op & I think this is too long to wait, especially when I have an aggressive cancer! I’m starting to fret about a recurrence! Thank you! Shaz
Thanks for your query. I'm sorry to hear about your diagnosis - it sounds like you've had a roller-coaster ride over the past few months.
There are guidelines within England about time scales between surgery and radiotherapy but not in the rest of the UK. Generally, radiotherapy should start within a few weeks of surgery but this is dependent on healing after surgery, infections related to chemo etc so it can vary from person to person. I completely understand that you are concerned given the aggressive nature of your cancer, and as it is causing you to fret, I would definitely chase it up with your breast care nurse or oncologist. If you have recovered well from chemo and have had no healing issues following your mastectomy, I would have expected you to have had your planning scan by now at the very least.
Do chase this up, at least to put your mind at rest if nothing else.
My local hospital is stating verbally and in their treatment booklet that the wait for radiotherapy is 12 weeks from recovery, in my case lumpectomy with wide excision. Surely that is too long a wait when the optimum is reckoned to be within 4 weeks? Isn't there a greater risk of recurrence if EBRT is delayed? The prospect of the treatment is bad enough with feeling my health is further compromised.
Hello Princess Betty
There is a small amount of evidence that says radiotherapy is more effective the sooner you have it, but for a lot of women, the reality is often different due to post-surgical infections, poor healing etc. Following lumpectomy, the radiotherapy is a 'belt and braces' approach, an insurance policy if you like, to reduce the risk of recurrence even further. This means that although there are guidelines as to when this should be given, you will still get a benefit even though it might be 12 weeks or more since your surgery.
It is natural to worry when you read about guidelines and 'best practice' etc, but guidelines are based on an uncomplicated scenarios and unfortunately, complications will often happen. There are lots of women who have had long delays due to healing issues, complications following chemotherapy and other factors delaying things. The risk of the delay having a detrimental effect on your overall risk of recurrence is extremely low.
Thank you. That's reassuring. I'm still aiming to get Iort. The trial may still be running, but the local hospital consultant knew nothing of it and there is difficulty getting an oncologist even where the hospital has surgical space.
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