yanyan
02-20-2013, 12:14 PM
I am debating whether i should have a non skin sparing mastectomy / have only the affected skin area ( seems to be under control with tykerb and xeloda ) removed / or reirradiation. Here are my thoughts:
1. A non skin sparing mastectomy after the initial skin sparing mastectomy seems to be very drastic. I am afraid if skin mets comes back, the cons will overweigh pros.
2. Having a local excision is what i would go for. Since the tumor cells are in the lymphatic vessles anyways, a wide excision maybe over do. But isn't a non skin sparing mastectomy a standard treatment for IBC which also travels through lymphatic vessels?
3. I am not inclined to have the breast area reirradiated. According to my radiaologist, if the expander were not there, my local recurrence to skin would have been a chestwall recurrence. Since the tumor cells were found in the lymphatic vessels, he thinks my chestwall is also affected. (But there is no solid tumor identified on recent PET scan ).So when he treats me he would have to reirradiate the chestwall and decides what dosage i will get because it will affect my lungs.
My concern about reirradiation is that it will continue to damage my blood vessels in the breast area, lung and chestwall areas. I am afraid if there is another recurrence in my lungs, breast areas or chestwall, chemo drugs won't be effective for me because of insufficient blood supply in those areas. It means i will need radiation again. I can't imagine the damage going through radiation 3 times. I will probably die from severly damaged heart mussels and lungs.
Need your input on reirradiation.. Thanks !!!
1. A non skin sparing mastectomy after the initial skin sparing mastectomy seems to be very drastic. I am afraid if skin mets comes back, the cons will overweigh pros.
2. Having a local excision is what i would go for. Since the tumor cells are in the lymphatic vessles anyways, a wide excision maybe over do. But isn't a non skin sparing mastectomy a standard treatment for IBC which also travels through lymphatic vessels?
3. I am not inclined to have the breast area reirradiated. According to my radiaologist, if the expander were not there, my local recurrence to skin would have been a chestwall recurrence. Since the tumor cells were found in the lymphatic vessels, he thinks my chestwall is also affected. (But there is no solid tumor identified on recent PET scan ).So when he treats me he would have to reirradiate the chestwall and decides what dosage i will get because it will affect my lungs.
My concern about reirradiation is that it will continue to damage my blood vessels in the breast area, lung and chestwall areas. I am afraid if there is another recurrence in my lungs, breast areas or chestwall, chemo drugs won't be effective for me because of insufficient blood supply in those areas. It means i will need radiation again. I can't imagine the damage going through radiation 3 times. I will probably die from severly damaged heart mussels and lungs.
Need your input on reirradiation.. Thanks !!!