Seeking advice on breast cancer treatment options

You can ask if accelerated radiation would be an option for you. It is one week. https://www.breastcancer.org/research-news/accelerated-rads-has-same-effect-as-traditional

Tumor grade and lymph node results should be considered when deciding if you want to skip radiation.

I haven't heard of accelerated radiation. I will ask about it! Thank you!

As for tumor grade, my biopsy showed a ki67 of 5% and after multiple ultrasounds and an mri so far no lymph nodes seem to be involved. Of course, the sentinel node biopsy will be the final determining factor.

And the oncotype score done at surgery will help determine the likelihood of recurrence which is why you would want radiation in the first place. It should be low like the KI, but talk to your dr about it as well.

Thank you!!

I had a KI67 of 2. My oncotype was 16. A low Ki is favorable but it also focuses on what tumor suppressor or housekeeping genes are mutated. Mine was 8mm until they actually went in and it ended up being 1cm. No nodes. Since the margins were clear I qualified for only 5 days of radiation. The margins have to be clear Now I’m on Tamoxifen Good luck. This all truly sucks!

Also the 5 days are every other day.

It does suck, the tamoxifen scares me. Meds and I never seem to have a great relationship it seems. It takes forever to find a med that I don't have a severe reaction to. For the 5 days of radiation, do they give you the entire 6 weeks worth during those 5 days? Or is it just smaller doses? Wondering if the side effects are the same?

I was scared to death about Tamoxifen too but my only side effect was a 7lb weight loss so I’ll take it. Most women really don’t have side effects, we just hear of the ones that do. That said I’ve never had reactions to drugs BUT you won’t know until you try and they can counteract some side effects. The radiation dose is high, not sure if it’s the exact dose of full term but it’s close and it just focus on the tumor site with the surrounding margins. The only side effect I had with that was after the final dose it looked like I had a little too much sun. Then about a week after it was itchy, they should give you a steroid and recommend Aquafor. But I was never tired.

I have IDC in right breast. My cancer is even smaller than yours, unless it has grown since biopsy. My surgeon is planning a lumpectomy. I'll be having accelerated radiation unless something happens to change it. It will be 2 treatments per day for 5 days. I personally wouldn't want to skip anything that could help save me later down the road.

Get a 2nd opinion on everything. They expect you to do it. I have the same type as you. My oncologist said chemo first then surgery via lumpectomy then radiation then hormone pills. I told her chemo fine, double mastectomy so no worries about margins, absolutely no radiation, hormone pills ok. Just got my chemo port yesterday and had to cancel my 1st chemo treatment due to Hurricane Milton here in Florida. Good luck.

Interview radiation oncologists now and get their perspective. Also see if proton beam therapy is an option. I’m leaving the state to get proton beam therapy. 2 weeks for partial breast radiation, 3 for full breast. I had a lumpectomy— a much easier surgery than mastectomy/reconstruction to recover from. Definitely get a second surgical opinion. Make informed decisions. The time between diagnosis and settling on a treatment plan is the most stressful part of this all imo.

Treatment decisions can feel overwhelming, especially when weighing factors like travel distance for radiation against other options. Many patients in similar situations find it helpful to seek a second opinion from another oncologist who can review your specific pathology and discuss all available treatment approaches, including the pros and cons of different margin strategies. Consider connecting with other community members who may have faced similar decision-making challenges - their experiences could provide valuable perspective as you work with your medical team to find the best path forward.