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Breast Cancer/Mastectomy after lumpectomy

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Question
I am 65 years old, currently completing A/C +T chemo following lumpectomy for an aggressive 5 cm triple negative breast cancer with 0 of 2 nodes negative.  
My bra size is 32J and the breasts are very pendulous. Because I would need to move to another community for 6 weeks' prone radiation, I am considering bilateral mastectomy after chemo.
My oncologist says removing breasts doesn't matter since my triple negative will come back in liver, lungs or brain. And my surgeon strongly favors lumpectomy versus mastectomy.
Would you recommend I travel for the prone radiation, pursue the double mastectomy option, or agree to non-prone radiation at a local facility? And do you agree that treatment of the breast in triple negative is not significant since recurrence occurs in other organs? I have not been able to find statistics on this.
Thank you.

Answer
I have to agree with your doctors even though the radiation therapy of the operated breast (lumpectomy) is made mainly to decrease the risk that the cancer comes back there locally. Yes you can have mastectomy instead (either just on the operated side or bilaterally) and that would make radiation therapy more or less unnecessary. But in my opinion that is using more surgery than necessary. Instead I do recommend the radiation therapy. The main treatment to decrease your risk that your cancer spreads is your chemotherapy. So since I think mastectomy is more surgery (and therefore more risks) than is necessary I do recommend radiation therapy as planned! But of course the choice is yours! Good luck whatever you decide!

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Claes-Gustaf Nordquist, M.D.

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I`m a doctor of medicine and a specialist in radiation therapy and medical oncology. I have long experience in diagnostics and treatment of breast tumours.

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I'm a Doctor of Medicine and specialist in Medical Oncology and Radiation Therapy educated & trained in Sweden. Now retired. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps.You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128 I have no restrictions on the number of questions there.

I also answer questions about Oncology (General Cancer), General History, Military History, Brain Tumors, Colon Cancer

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I'm a medical doctor and specialist in medical oncology and radiation therapy.

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