Expert: Claes-Gustaf Nordquist, M.D. - 1/25/2008

Question
I had a mastectomy on my right breast in December.Two lumps had been found on core biopsy and also had calcifications between the 2 lumps. One lump DCIS and one invasive.Pathology after mastectomy showed total size of lumps was 2.1cm,which put me into Stage II. Only sentinel node found with cancer,14 nodes cancer free.Margin was "close",being less than 1cm.Undergoing chemo with Taxotere and Cytoxan.I'm postmenopausal,so will be taking Femera for 5 years.I already have tissue expander in place for reconstruction.Was going to have implant, but because of possible radiation,these plans will change. Breast surgeon had thought I wouldn't need radiation,but oncologist thinks I should because of the close margin.I had read that tumors over 5 cm,and more than 4 nodes and positive margin meant radiation. Does having only one criteria met mean radiation is advisable? How is radiation to the area different from already having chemo to kill the cancer cells? What are effects from radiation if the tissue has already been taken from the area and skin is thin.(I can feel a stitch under the skin from mastectomy surgery).I find all kinds of answers for radiation after lumpectomy but not much after a mastectomy. Is radiation adviseable after mastectomy with above conditions? Thank you.

Answer
I agree with your oncologist that radiation there is necessary and should be done! And it should not be difficult to do. Well it will deliver a higher cancer killing effect locally and that is what we want. If done carefully it should not be much of a problem! Good luck!