Yes, radiation for me

Due to my stage, radiation was a necessary part of treatment.  In 2017, the standard of care was 6 weeks for my stage III breast cancer.  I was offered a study at KU for 4 weeks, the standard of care in Europe.  They were getting equivalent outcomes with less radiation (less side effects), however there was only a small subset of people in the study with positive lymph nodes.  For that reason, I opted for the 6 weeks.  I am the type of person who would likely berate myself if my cancer returned, thinking "if I'd only had the 6 weeks of radiation it might not have returned".  

I believe now the standard of care in the US is less, so no one might even offer 6 weeks anymore.  Decisions are based upon pros and cons, what is known at the time and what things are most important to you.

If I was diagnosed in 2024, and the outcomes are known to be good with 4 weeks for stage III, I sure as heck would have loved having less radiation!  Radiation plus my lymph node dissection are co-responsible for my lymphedema issues.  

An interesting note:  I asked my Radiation Oncologist to pretend like I was a med student and teach me about Radiation Oncology for breast cancer. She was most happy to share these things I did not know.  She explained that 5 years prior (so 2012 and before), radiation for breast cancer was whole beam meaning blanketing the whole area.  Subsequently radiation became focused to certain areas (tumor bed, lymph nodes on affected side in the neck, supraclavicular region, mediastinal and axillary and some of the chest wall near tumor).  The radiation machine in 2017 could pinpoint these areas and relatively spare the others.  Treatments continue to be fine tuned to provide adequate treatment and limit side effects.  

This is the doctor in me speaking:  It is fine to ask if the machine being used is the best or latest technology in the greater Kansas City area.  It is absolutely fine to get a second opinion from a National Cancer Center to learn if what they have to offer provides a survival advantage or lower side effects to the machine at your home institution.  Doctors truly are not offended by these questions!