Radiation is often used to control for local recurrence with breast cancer. When a lumpectomy is performed, even if clean margins are obtained, radiation is indicated almost 100% of the time. This is because there is the possibility of some stray cancer cells wandering the breast tissue that increase the likelihood of local recurrence. Post-lumpectomy radiation significantly reduces this risk.
With a mastectomy, radiation is NOT indicated if 3 criteria are met. The criteria are as follows:
1. Tumor less than 5 cm in size
2. Negative lymph nodes
3. Completely clean margins of greater than 2mm (it is possible that the cancer gets too close to the skin or chest wall)
Up until today I had 2/3 of these criteria met. This is one of the reasons I chose mastectomy. I was (kind of) gambling on getting completely clean margins in hopes of avoiding radiation. Today, I won that gamble. My margins are clean! As far as I know, I will NOT be needing radiation. Although radiation techniques have improved significantly it is still a 5 day/week treatment that lasts 6 weeks (unless you are lucky enough to get into a clinical trial). Not needing radiation also opens up my reconstruction options. Options are good. Also, long term implications of radiation (for a 35 year old planning to live another 70 years:) are not completely clear.
Besides the good news, I think I am healing right on track. I once again feel great and if it weren't for some physical limitations and discomfort from the expander I'd be rearing to go. I've been told that I can walk as much as I feel like. Today I walked around the block whenever it stopped snowing. Tomorrow it is supposed to be nice, so maybe I'll increase distance and duration:) Thursday is my first follow-up so I'll know for sure if my healing is on track.