Radiation Therapy Concerns: Options After Stage II Breast Cancer Surgery

Radiation therapy issues

Dr.
Chen: Hello! I have two questions I would like to ask you, thank you! 1/ After a lumpectomy for stage II breast cancer, is it possible to choose not to undergo chemotherapy? Since the lymph nodes are clear, the doctor mentioned that I could opt for radiation therapy and continuous medication for ten years.
2/ The surgery has already been completed, but due to a high volume of patients, my radiation therapy has been scheduled for six months later.
Will delaying radiation therapy for six months affect the treatment's effectiveness or increase the risk of recurrence? Thank you, Dr.
Chen, for answering my questions; I truly appreciate it! Ms.
Li

Ms. Li, 50~59 year old female. Ask Date: 2016/05/31

Dr. Chen Sirong reply Oncology

Ms.
Li / 54 years old / Female
1/ Can a patient with stage II breast cancer choose not to undergo chemotherapy after a lumpectomy? Since the lymph nodes are clear, the doctor mentioned that radiation therapy and continuous medication for ten years are options.
A: It's difficult to assess without knowing the specific type of cancer cells.
If it is invasive ductal carcinoma stage II, we typically recommend chemotherapy.
The surgery has been completed, but due to a high volume of patients, my radiation therapy has been scheduled for six months later.
Will delaying radiation therapy for six months affect the treatment's effectiveness or increase the risk of recurrence?
A: If chemotherapy is administered, radiation therapy should ideally start 3-4 weeks after the last chemotherapy session.
If radiation therapy is to be given directly after surgery, it is best to initiate it within 4-6 weeks post-surgery.
Thank you, Taoyuan Hospital, Dr.
Chen Sih-Rong.

Reply Date: 2016/05/31

More Info

Dear Ms. Li,
Thank you for your questions regarding the management of Stage II breast cancer following surgery. It’s important to address your concerns thoroughly, as the decisions made during this phase of treatment can significantly impact your prognosis and overall health.

1. Can you choose not to undergo chemotherapy after local excision for Stage II breast cancer?
Yes, it is possible to forgo chemotherapy after surgery for Stage II breast cancer, especially if your lymph nodes are clear of cancer. The decision to use chemotherapy often depends on several factors, including the tumor's characteristics (such as hormone receptor status and HER2 status), the size of the tumor, and the overall health of the patient. In your case, if your oncologist has indicated that radiation therapy and a ten-year course of hormone therapy (like an aromatase inhibitor or tamoxifen) are sufficient, this may be a reasonable approach.
Radiation therapy is typically recommended after breast-conserving surgery (lumpectomy) to reduce the risk of local recurrence. Hormone therapy can further decrease the risk of recurrence, particularly in hormone receptor-positive cancers. However, it’s essential to have a detailed discussion with your oncologist about the potential benefits and risks of omitting chemotherapy, as well as the specific characteristics of your tumor that may influence this decision.

2. Will delaying radiation therapy for six months affect treatment outcomes or increase the risk of recurrence?
Delaying radiation therapy after surgery can raise concerns about the potential for cancer recurrence. Generally, the sooner radiation therapy is initiated after surgery, the better, as it helps to eliminate any remaining cancer cells in the breast and surrounding tissues. However, the exact impact of a six-month delay can vary based on individual circumstances, including the biology of the tumor and the overall treatment plan.

Research indicates that delays in starting adjuvant radiation therapy can be associated with a slightly increased risk of local recurrence, particularly in patients with higher-risk features. However, the degree of risk can depend on various factors, including tumor size, grade, and hormone receptor status. In your case, if your oncologist has assessed that the delay is manageable given your specific situation, it may be acceptable.
It’s crucial to maintain open communication with your healthcare team. If you have concerns about the timing of your radiation therapy, I encourage you to discuss them with your oncologist. They can provide insights based on the latest research and your unique clinical scenario.

In summary, while it is possible to forgo chemotherapy in certain cases of Stage II breast cancer, the decision should be made collaboratively with your healthcare team, considering all aspects of your diagnosis and treatment plan. Additionally, while a delay in radiation therapy can raise concerns about recurrence, your oncologist will be best positioned to assess the risks and benefits in your specific case.

Thank you for reaching out with your questions, and I wish you the best in your treatment journey.

Warm regards,
Dr. Chen

Similar Q&A

Understanding Breast Cancer Surgery and Post-Operative Treatment Options

Hello Doctor, My mother has been undergoing regular mammograms every six months and was diagnosed with breast cancer last week. The tumor is located at the 9 o'clock position in the right breast, measuring 1.2 cm, and is a single tumor (the doctor mentioned that lymph node...

Dr. Lai Yicheng reply Oncology
Dear Madam, Thank you for your letter. Here are my responses: 1. If the malignant tumor is small, partial resection followed by adjuvant radiation therapy can be considered. However, if your mother has multiple benign fibromas in both breasts as you described, total mastectomy ...

Should I Choose Radiation Therapy After Breast Cancer Treatment?

I am a breast cancer patient and have just completed my second treatment. I am currently facing the decision of whether or not to undergo radiation therapy. I hope to gain insights through your professional analysis to help me find an answer. Can you assist me? Thank you! A breas...

Dr. Yang Youhua reply Oncology
Hello Ms. Cheng: You have not clearly described your clinical condition, such as how many axillary lymph nodes are infected, the size of the tumor, the extent of invasion, and its location, etc. If you undergo a local excision, radiation therapy is essential to prevent local recu...

Understanding Radiation Therapy Scope for Breast Cancer Treatment

My younger sister was initially diagnosed with stage I breast cancer due to a tumor in her right breast. After tumor excision and sentinel lymph node biopsy, it was found that there was one tumor metastasis in the sentinel lymph node. During the surgery, axillary lymph node disse...

Dr. Wang Yifen reply Radiology
Hello, the treatment for breast cancer includes surgical intervention, medical therapy, and radiation therapy. The treatment approach may be adjusted based on the histopathological classification, the site of tumor invasion, and the consideration of the benefits and side effects ...

Effects of Radiation Therapy on Early-Stage Breast Cancer Patients

Hello, I would like to understand the effects of radiation therapy after breast cancer treatment. A stage I breast cancer patient has undergone surgery abroad and had a tissue expander implanted. The doctor has suggested that radiation therapy may be necessary, along with medicat...

Dr. Chen Sirong reply Oncology
Linlin, a 29-year-old female patient who underwent breast reconstruction, can still receive hormone therapy, chemotherapy, or radiation therapy postoperatively, which does not conflict with further treatment for breast cancer. Future follow-ups, including outpatient physical exam...