Today was treatment #24. I have four left to the full breast, and then 5 "boosters" to the scar area only. I googled to try to find out more about this last detail and this was the only relevant article:
Clips and scar as the guidelines for breast radiation boost after lumpectomy
F. Kovnera, f1, R. Agaya, O. Merimskya, J. Stadlerb, J. Klausnerc and M. Inbara a Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Israelb Department of Surgery “A” Tel-Aviv University, Israelc Department of Surgery “B” Tel-Aviv University, Israel Accepted 12 April 1999. Available online 12 May 2002.
Abstract Background and Aims: Breast-conserving therapy in early breast cancer is equally effective as mastectomy, with advantages of cosmesis and quality of life over mastectomy. Local control is improved when entire breast irradiation is combined with a radiation boost to the tumour bed.
Methods: Localization of the tumour bed was compared in 45 consecutive patients using surgical scar and radiopaque clips placed intra-operatively in the lumpectomy cavity.Results : The area (A) of the radiation boost field and volume (V) of the tumour bed, designed on the basis of scar (AS and VS), were 1.4 times larger than those designed on the basis of the clips (AC and VC). AS and VS missed about one-quarter of the tumour bed which had been delineated by clips intra-operatively, while about one-half of it encompassed tissues beyond the AC and VC.
Conclusions: A boost planned by scar dimensions can miss a substantial portion of the tumour bed, compromising local control. On the other hand, a substantial amount of breast tissue beyond the tumour bed can be unnecessarily irradiated, compromising cosmetic treatment results. Thus, the scar provides an inadequate landmark for radiation boost planning in breast-conserving therapy.
So, I am not quite sure what to think. Probably a lot has changed since this article was published in 2002. What they did today was to apply a colored plastic patch in the shape of my scar to the area on my breast where the scar is; a crescent shaped scar that runs from approximately 1 o'clock to 4 o'clock. Lots more Sharpie lines. I think this tech really wanted to be a tattoo artist. Then Dr. P was called and finally came in to check the placement. For this treatment, the accelerator head has a kind of focused beam coming through a lens with a diameter of about 5-6", and it comes pretty close to my skin.
Tuesday is meet with the Dr. day. I wait an interminably long period of time for Dr. P. Everything is good (except my blood pressure!).