To radiate or not radiate

I met with the radiologist, Dr. Warner, yesterday. She was very informative and went over everything that I had been through. She had the pathology report which she went over with us to make sure that we understood the findings. While I had been diagnosed with invasive ductal carcinoma, no invasive cancer was found in the breast tissue from the mastectomy, only non-invasive ductal carcinoma. And that cancer had been removed with clean margins around it, showing that they had gotten all of it. So the chemotherapy did its job and killed the invasive cancer tumor.

Now the only worries that we have are the lymph nodes, one of which did show cancer and could have been in other lymph nodes that weren't removed. There were only 3 lymph nodes removed (one positive for cancer, one 'dead' due to the chemotherapy, which had probably been cancerous, and one normal lymph node). Dr. Warner said that they like to see more removed, around 10 lymph nodes so that they have a better idea of whether there was spreading of the cancer or not. She felt it was in my best interest to receive radiation therapy in two sections to cover the lymph nodes along the arm pit area and up above the clavicle where there are more lymph nodes, as well as the lymph nodes along the sternum. One of these lymph nodes along the sternum had shown uptake of sugar on the PET/CT scan that I had received back in March which could possibly mean cancer as well. The radiation destroys the DNA of cells, but while our normal cells can remake the DNA and repair itself, cancer cells cannot repair their DNA so they are destroyed.

The only confusing part to me is the numbers for 'survival'. The radiologist was saying that by receiving this radiation therapy I would be increasing my chances of not having the cancer return by another 10%. Okay, that isn't that big of a number to me. But the way she was saying it, she made it sound like a significant amount. Also by receiving the radiation therapy my right lung will be affected in a couple of areas with some scarring that could give me some trouble in the future, but she said this was a very small percentage. If I wanted to become a marathon runner after all of this, the scarring would not prevent me from doing so. My thyroid might also be affected and there is a chance that I might have to take some medication in the future for a hypo-thyroid problem. And there is also the chance of some rib fractures the first 1-3 years after the treatment, but also a small percentage.

I was told that I could receive reconstruction surgery on my breast, but as I am receiving radiation therapy which tightens the skin and 'sunburns it', they recommend waiting about a year before having this surgery performed.

Tomorrow, Friday, I will be receiving a CT scan with dye to the chest to see if the small nodules in the lungs have changed or not. I believe there had been about 5 nodules found in my lungs before chemotherapy had been started. They felt that at least 4 of them were due to scarring from infection, dust, etc, but they weren't sure about the 5th one. They had said that if any of these disappear after chemotherapy then there was a good chance that the cancer had metastasized to the lungs. Next week, on Tuesday, I go in to see the radiologist to begin the preliminary preparations for radiaton treatment which will probably start within a couple of weeks. I should hear the results of the CT scan at that time.