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HomeAnswersInternal Medicinebreast cancerIs radiotherapy recommended for breast cancer?

Do I need to get radiotherapy for breast cancer?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Sivanath

Medically reviewed by

iCliniq medical review team

Published At November 11, 2016
Reviewed AtAugust 8, 2023

Patient's Query

Hi doctor,

I had pure mucinous right breast cancer and had nipple sparing mastectomy. Do I need radiotherapy? My report showed 0/18 free lymph nodes, free margins, ER 8/8, PR 8/8, HER2 zero and KI67 8%.

Answered by Dr. sivanath


Welcome to icliniq.com. For cases involving mucinous and strongly hormone-positive tumors with no positive lymph nodes, adjuvant endocrine therapy is typically sufficient. Could you please provide information about the size of your tumor? This detail will help in providing more precise recommendations.

Patient's Query

Thank you doctor,

Tumor size is 6 x 5 x 3 cm with an inadequate margin after excisional biopsy, which was done three months ago. After 15 days, I got a nipple sparing mastectomy with level 1 and 2 axillary lymph node dissection and Latissimus dorsi reconstruction. The pathology revealed 0/18 free lymph nodes, free margins, ER 8/8, PR 8/8, HER2 0 and KI67 8%. I started on Tamoxifen 10 mg two tablets after dinner. I want to know if hormonal treatment is enough or radiotherapy is necessary. I am afraid of the long term side effects of radiotherapy. I have attached the pathology reports. Many thanks.

Answered by Dr. sivanath


Welcome back to icliniq.com.

The tumor size was T3. However, based on present research, mucinous is favorable histology and do not need radiation with node negative status. I will stand to my point that it is important to continue endocrine therapy. I will strongly recommend to continue Tamoxifen. As you are perimenopausal you should get your FSH (follicle stimulating hormone) and estradiol level to see if you have reached menopause. You should also be aware of the main side effects of Tamoxifen, which may include thromboembolic events, sweating, hot flushes, vaginal bleeding, elevated calcium, altered lipid profile, depression, body pain, muscle pain and risk of endometrial cancer. You should continue screening of other cancer like annual mammogram, cervical Pap smear and baseline DEXA (optional) based on your risk of age related osteoporosis.

Consider working on preventive health including physical activity, nutrition and weight management. You may take recommended adult vaccination as per local guideline. All the health recommendation for the general public also applies to you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. sivanath
Dr. sivanath

Internal Medicine

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