Radiotherapy treatment

i had a mastectomy and breast reconstruction on the 11th September 2024, my biopsy results showed 11.2 cm high grade DCIS not cancerous. breast surgeon suggested radiotherapy to kill any cells left in my own skin or at the back chest wall as there was no clear margin of clear tissues. My worry is the effect of radiotherapy to the heart, lung, and skin cancer?

  • Hello and thanks for posting

    I'm sorry about everything you've been through and how worried you feel about the possible effects of radiotherapy on your heart, lungs, and skin.

    As there wasn't a clear margin of healthy tissue around the area with high grade DCIS, radiotherapy is usually recommended as an additional precaution to reduce any small chance of recurrence. It aims to destroy any remaining abnormal cells that might have been left behind.

    Radiotherapy techniques have come a long way over the years helping identify the exact area to be treated and working out the most effective radiation dose, while limiting the amount of radiation to surrounding tissues.

    Techniques like 'deep inspiration breath hold (DIBH)  is when patients are asked to take a deep breath during radiotherapy and hold it briefly. This can help to protect the heart and lungs especially if the treatment area is close to these organs.

    Skin reactions can happen and it's common for the treated area to become sore or discoloured temporarily. Long term changes in the skin are possible, but they are usually managed carefully with advice from your radiotherapy team.

    I think it is important that you understand all the information given to you by the specialist team to help you decide what to do. There is often quite a lot to take in and it can be overwhelming,  so I would encourage you to get back in touch with the team if there is anything you are not sure about or want to discuss more fully.

    If you have a breast nurse specialist involved in your care then perhaps they can provide you with further information. You often have to call and leave them a message and they will get back to you.

    You may also like to look at Macmillan Cancer Supports information on making treatment decisions as it provides some useful information and tips to think about that you may find useful.

    I hope this has been of some help. Please get back to us if you need any more information or support.  You may find it helpful to talk things through with one of the nurses on our helpline.  The number to call is Freephone 0808 800 4040 and the lines are open from 9am till 5pm Monday to Friday.

    Kind regards,

    Celene

  • Thanks for your reply,

    Will those microscopic cells that possibly left behind they could turn into cancer and spread if i didn't do radiotherapy?

    cant I have regular scan or mammogram to check and see if those cells have changed?

    If I choose not to do radiotherapy, will those cells turn into a lump where i can feel or might stay small but turn to invasive cancer?

    Thanks

  • Hello and thanks for your further post

    When margins are not clear high grade DCIS has the potential to turn into an invasive cancer if any microscopic cells are left behind. This is why radiotherapy is usually recommended as an additional precaution to reduce any small chance of recurrence. It aims to destroy any remaining abnormal cells that might have been left behind.

    Although scans can sometimes help to detect new abnormalities, microscopic cells can be too small to be visibly seen until they progress. If left untreated any remaining cells may form a small lump but this isn't always the case. In high grade DCIS cells can sometimes become invasive and spread without forming a noticeable lump.

    Your breast care team will discuss this in more detail with you when your appointment comes through.

    Kind regards,

    Celene