[Lani]

Not to make you anxious, but food for thought if any way to lessen likelihood and perhaps prevent:

one of the rare complications of regular whole breast radiation therapy is brachioplexopathy, which usually occurs years later and can be debilitating and painful.

Since this radiation is not for the whole breast but SPECIFICALLY FOR the area near/adjacent to/possibly including the brachial plexus, I would get a second opinion on the radiation therapy aspect of it--are there any techniques, what does/does not need to be in the field, different types of brachial plexus treatments which might lessen the likelihood of that.

As I recall you are a nurse by training, so would be able to feel comfortable interpreting what they tell you.

I know little about radiation therapy, but know Stanford and a few other places (Stanford has the most experience) are using cyberknife for things other than brain tumors/mets, where it is of ultimate importance to have pinpoint accuracy of delivery of the SRS. I will try to later look up brachial plexus and radiation therapy (I am currently travelling) and see who might have written papers on it. Feel free to do so via ENTREZ PUBMED in the meantime.

Frank Vicini in Detroit seems also to be an expert on breast radiation, APBI. but you may need someone who is not necessarily a breast radiaiton expert

This may come up with radiation for sarcomas etc ie sparing the brachial plexus.

There may be no way to spare it since it is close if not involved, but perhaps IMRT or other techniques. There is no data to support using proton beam from what I looked up in the past, but this may have changed (lots of hype on proton beam, for which they charge huge amounts, but little data)

Is it the brachial plexus on your dominant (handed) side?

Since you are trying to irradiate near/at something which can suffer from the radiation therapy in a way that would affect your life (very rare for wbr, I don;t know the chances w radiation at/near it) I would certainly want to be sure they had the opportunity to think through all the options and choose the one they would want if it was their own problem!