My mother, 75, had a mastectomy. Is radiation therapy needed?

Question

Hi doctor,

My mum, who is 75 years old, recently had a modified radical mastectomy for stage 2B invasive carcinoma (tumor size 3x3, two nodes of 19 dissected had metastasis). Her biopsy result says that the NHS-grade is 3 and positive lymph vascular and perineural invasion, the skin and areola, and nipple are free of tumor, p2t2 N1a, DCIS-intermediate, the tumor is hormone-positive, both estrogen and progesterone, HER2 negative.

She is also a cardiac patient (atrial fibrillation, hypertensive). She has been advised of radiation therapy and hormonal therapy; we had a second opinion on radiation therapy and were told it is not required. So we are in a dilemma, if we have to proceed with radiation or not? Could you please give your opinion on whether radiation is required?

If so, what are the benefits? Does it cause any severe side effects? And do the benefits outweigh the risks? I appreciate any help you can provide.

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

According to your description, your mother has been diagnosed with cancer, stage T2, n1 (tumor 2, node 1), grade 3, ER/PR positive (estrogen and progesterone receptor testing), LVI and PNI (lymphovascular and perineural invasion) positive.

She is 75 years old with cardiac comorbidity. I would suggest radiation therapy, but I would also like to know which side of the breast is affected. I would need to see the patient in person to decide her treatment plan. The benefits outweigh the risks.

I hope this helps.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

The risk of radiotherapy for right-sided breast cancer is limited to lung problems in the long term and throat pain, skin ulceration in the short term. I would advise radiotherapy. But as I said, the final decision is after seeing the patient in person.

Take care.