Expert: Claes-Gustaf Nordquist, M.D. - 10/7/2006

Question

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Followup To

Question -
Dr Nordquist,
I see my oncologist regularly.   I've been cancer free since 1999, after 2 lumpectomies and radiation.   However, lately my radiated breast feels tender or sore.   While it isn't anything I can't live with, makes me wonder.   My oncologist says I am doing great and not to worry, I guess.   But he isn't radiologist and I can't talk to my radiologist because I have moved in the past 7 yrs.   

Does this seem unusual to you?   Is this a possible side effect years later?   Thanks, Anita
PS If anyone has a similar side effect this much later, please contact me at anitamich@aol.com.   It would be greatly appreciated.

Answer -
No, unfortunately it does not make me wonder. It is not a cancer symptom but is probably a late symptom of your previous postsurgical therapy. If I understand your question correctly you have had 2 lumpectomies, both in your left breast and in both cases with postsurgical radiation therapy. The postsurgical therapy was in that case on both occasions done according to standard postsurgical praxis, but since I suppose they were both in the same, your left, breast it was very difficult or impossible to avoid very high radiation dosage in some areas of that breast. These high radiation doses can cause the symptoms you describe. Unfortunately there is no treatment for these symptoms. They are most probably a nuisance but are in themselves not dangerous. Such postradiation effects often come late after many years.

Dr,
I'd like to reclarify.   The second lumpectomy took place 2 weeks later because the lab report indicated that she/the surgeon needed to take/remove a greater margin around the tumor/calcifications............stage one.   So I only had the radiation once/6 week set.   Does that change your answer now that you know all the facts?   And I had the prerequisite 5 yrs of tomoxiphen afterward.   Off that for 2 yrs now.   Thank you for your very prompt answer.   It's greatly appreciated!

Answer
Yes. The Tamoxiphene treatment does not change anything. Actually with this information overdosage should be less likely, however the increased treatment volume due to the extended margins after the second surgery MAY (should not but may) have increased your total dosage above tolerance levels. That anyway would explain your symptoms. To know for sure a study of your treatment plan would have to be done.