Decision time

Hi Ruby, I had lumpectomy July 2025, 9 radiotherapy September 2025 and have been fine all through it. Was driving all through radiotherapy and part from slight fatigue have been great. I had TNBC, but refused chemo after discussion with oncologist, but can’t take any medication for this type of cancer.

Not sure why you want to omit radiotherapy, but if it was because of side effects I wanted to say I had none apart from slight swelling which I think was more to do with lumpectomy.

Each decision is a personal choice so good luck whatever you choose to do.

Thank you for replying.  Very helpful.  I had estrogen positive breast cancer, very low grade.  The radiologist said that I am safe to omit radiotherapy if I continue to take the hormone therapy ( which has no side effects for me).  My choice is not because of radiotherapy side effects more that if cancer ever comes back on that side, I can choose radiotherapy then ( as one can never have it twice on the same side).  

I am nearly 70
I have had 5 days of RT recently. I considered my options very carefully and decided to go with it as the "score" for the likely reduction in recurrence rate ffor RT for my individual case was significant. I felt that it was worthwhile having it to hopefully "mop up" any rogue cancer cells that might be floating around even after my chemo. I had no ill effects from RT apart from a tiny bit of soreness, and short term fatigue. I had had a successful mastectomy, clear margins and no lymph node involvement, but the pathology revealed that I had had an invasive spread to the breast skin which elevates the risk factor for recurrence. I feel I made the right decision in my circumstances.

Have you looked at the NHS "Predict" tool to assess what benefit RT might give you Ruby?

 I have recently turned down another treatment option after weighing up the potential small potential benefit against the risk of some rather nasty side effects. Just because you are eligible for a particular therapy doesn't mean you have to take it, but they DO have to offer it. After I had made my decision and justified it to my Oncologist he told me that he thought I had made a good decision for my particular case. 

Good luck in deciding the way forward. For what it's worth (I'm no expert) I think your instincts are good on this one.

Hello Ruby, oh I certainly understand how you feel making this decision.  I had DCIS in right breast and a 3mm stage 1 estrogen positive tumor in the left breast.  Well to make a long story short.  I was put on Anastrazole and did well for about 3 years on it but then started to have too many issues with it so now in letrozole.  So far so good but only been taking it for about 3 weeks.  But let me get back to my choice to have radiation .   Both my oncology surgeon and the radiologist highly recommend radiation as the margins on the breast with DCIS was less than 2mm so had radiation to both breasts and then 5 boosters treatment to the right side.  Did really well and was very apprehensive about it especially having it done on both breasts.  Another reason I decided on radiation was my breast size.  I am small breasted 32A and certainly if I had another tumor I would have needed a mastectomy anyway so wanted to give myself the best odds.  If I had been larger breasted I probably would have made another choice as if cancer returned I could have had another lumpectomy and then radiation at that time.  Sorry for being so long winded but wanted to give you details.  

Hi there

It's great to hear you are doing so well. I am a wee bit different in that I had to have Chemotherapy then a lumpectomy. I am now at number 12 if of 19 radiotherapy sessions.

I just wanted to say that I have found radiotherapy not bad at all. Of course everyone is different. I just wanted to let you know that I have found it in no way as bad as I thought it would be.

All the very best for your recovery and future x

Thank you for your thoughts.  More interesting developments. I asked for more help from the hospital.  A nurse phoned and said I should definitely have the radiotherapy. Two hours later the head breast cancer radiologist phoned me and advised me not to have radiotherapy.  She quoted a lot of research about women my age and with stage 1 cancer with no spread.  She definitely thinks certain women are given too much radiotherapy and if it does recur on the same side have to have a mastectomy. I am meeting her again for further discussion.

Thank you for your reply.  It’s not the side effects that I am concerned about.  It’s the future.  Radiotherapy now on that side means never again on that side.  I will let you all know which way I decide with the radiologist s support.  Good luck with your journey.

Hi Ruby20250875e5 

I had similar concerns about radiotherapy and whether I should “save” it in case it came back. When I said this to the radiologists they told me it was not a hard fast rule it can only be given once and that it can be given a second time for some people. My oncologist even told me that the tattoos are used as markers for where previous radio has been administered during planning of radiotherapy in the future if needed. x

Goodness, it's bad enough having to make a decision, but doubly hard when you get conflicting advice from the specialists! 

That is interesting. I only had 5 sessions rather than the 15 they always used to do. They told me that there is strong research evidence that 5 has as much beneficial effect as the 15. I wonder if that also means that if the worst happens they are comfortable about doing more.