Radiotherapy- yes or no?

Hi Potassium8 

I was diagnosed with breast cancer in April 2022 and had a lumpectomy with sentinel lymph node removal, followed by chemo (EC and paclitaxel) and then 10 sessions of radiotherapy. None of this has resulted in lymphoedema, although I'm careful not to have any injections or blood taken from the arm on the side I had my lymph nodes removed from and I always wear gloves and long sleeves when gardening to avoid the risk of getting a cut on that arm.

Hi Potassium8   Can you discuss this with your GP or bcn or oncologist? Or maybe a oncology physio? I have some lymphoedema in my breast that sometimes creeps into my arm from radiotherapy. I think it is linked to my wound not being fully healed before the radiotherapy started and a lingering seroma… however, I am having scar therapy and this helps enormously. I am also active and do regular exercise and overall am not finding it problematic. I totally get not wanting to do treatment that might impact something so central to your identity but I think it’s worth getting professional advice from an expert.

Hello,  I read your post a few times and a couple of things I have a few thoughts about.  You have certainly been through a great deal.  

Oncotype DX test recurrence score may be beneficial as it can help to determine if radiation would be a benefit.  I don’t know if you had the test already but it may help you to make a decision.

One thing is your age.  You are very young so this may be another factor in wanting you to have radiation.  Lymphedema can occur from many things.  Surgery, lymph node removal radiation etc.  

I had radiation to both breasts after lumpectomies but was 72 years old so much older.  It was hard for me to make a decision but did have it done and so far am fine.  Lymphedema is a side effect that all breast cancer survivors need to be alert for as it can happen years after treatment ends.  We all need to be diligent no matter what treatments we have had done.

I wish I could be more helpful but there is no clear cut answer but we need to do what is the best approach at the time to give us the best chance for not having a reoccurrence.  Hugs to you.

I’m 16 months on from axillary node clearance which had given me seroma  issues and slight cording and 14 months on from 19 sessions of radiotherapy. The node clearance had shown no sign of cancer (it had been in 2 sentinel nodes) and so the armpit was not included in the targeted area. I feel a bit ‘fluidy’ in the breast from time to time but staying active seems to be the key. My skin burns didn’t blister and cleared up quickly though I did go around quite greasy with oatmeal moisturiser and emollient cream.
It sounds like you’re likely to be fairly physically fit which is good in general, particularly so for getting on well after cancer or other medical treatments. 
I balked at quite so much radiotherapy and hadn’t really wanted the node clearance, but I feel that the surgeon and the oncologist have advised me personally, as I am, within the context of what effects the treatments they’ve offered might have. 
There’s no guarantee of any desired or undesired effects I suppose, just relative likelihoods, but apart from making the choices one can also be aware of how to minimise or combat the undesired effects where possible. 
All the best to you. xx

Hi. I think you need to think what is the most risk, local recurrence or distant recurrence. 

with me for example, the margins were good so no fear of it returning in chest wall but oncotype came back as high risk for distant recurrence. 

radiotherapy is more targeted in one area whereas chemo is for full body.

Maybe weigh these two things up. 

Hi I just wanted to let you know that I had 10 sessions of radiotherapy and no issues .I am 33 and had a lumpectomy and after this I had cording down arm which was sore at the time but resolved on its own over a few weeks.tbh radiotherapy was a breeze for me.i used the cream they provide and no burns just slight redness. I myself would rather regret doing something than regret not doing it.best of luck what ever you decide 

I had the 5 day radiotherapy. Initially I thought about refusing it but was reassured by the oncologist it was low risk as they wouldn’t need to do the lymph nodes as there was no spread, just the scar area (chest wall) from the mastectomy. However I noticed they asked on my travel insurance application if I’d refused any treatment to which I could answer NO but it would have been a YES if I hadn’t had the radiotherapy. Seems some people get a choice about whether or not to have it whereas I was given a recommendation to have it. 

Hi. Did you not need chemo?