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>>>DR. JAY HARNESS: If you have a mastectomy, you usually do not need radiation therapy.
Now there are exceptions to this and the exceptions are a little technical. One of the exceptions
is if you had a big cancer originally called a T3 cancer greater than 5 cm in size that
is typically an indication even with a mastectomy for radiation therapy. That is part of what
is called the multimodality treatment of breast cancer.
Another indication is if you have what is called angiolymphatic invasion in the breast
tissue that came out with the mastectomy, “what do we mean by that?” Meaning, when
the pathologist works at the breast, they can see cancer cells floating or directly
invading into the little lymphatic channels or the little veins within the breast. That
is typically another indication for radiation therapy after mastectomy.
Another indication is having multiple lymph nodes involved in the axilla at the time we
take the lymph nodes out. Typically this is four or more lymph nodes are involved or fewer
than the four, but the cancer is growing out through the walls of the lymph nodes that
is called extranodal extension, so those are indications for radiation therapy after a
mastectomy.
Now, if you are a patient with stage I breast cancer and you have the choice between lumpectomy
plus radiation therapy, which is the typical combination versus mastectomy, the standard
stage I breast cancer, T1a, T1b, T1c, where the lymph nodes are negative and you chosen
now to have a mastectomy, there are very-very few indications in that setting that you would
in fact need radiation therapy.
The one that comes to mind is that even being lymph node negative smaller cancer there is
a positive margin. In other words, the cancer is growing into let us say the underlying
muscle here and even being stage I because there was a positive margin. In that set of
circumstances you might need radiation therapy as a way of local regional control, but the
typical standard patient with stage I or early stage II, short of breast cancer that does
not have any of the things that I have just talked about but you have chosen to have a
mastectomy with or without reconstruction. Typically you will not need radiation therapy.
Hi, I am Dr. Jay Harness and I want to share with you an important information that I believe
that every newly diagnosed patient with breast cancer needs to know.
Susan Denver: I am a breast cancer survivor.
Katherine Stockton: I am a breast cancer survivor.
Coree: I am a breast cancer survivor.
Susan Denver: And I want every woman to know…
Katherine Stockton: …about personalized breast cancer treatment…
Susan Denver: …and the Genomic Test.
Coree: A test that helps guide a woman and her doctor…
Katherine Stockton: …to the best treatment options for her.
Susan Denver: Pass it on!