Question about Radiation with Chemo

Can you tell me how long after surgery I might have to wait before starting chemo and radiation, if they're necessary.

If it takes 6 to 8 weeks to heal from a mastectomy and auxillory dissection, do they wait that long before starting? Would a reconstruction also take the same amount of time (generally speaking) to heal from first?

Please tell me your experiences.

My docs have me on a slightly different regimen because I'm in a BC study.
I did chemo (version 1) first to try to shrink the tumor. My last treatment was 1/13/04 and my white cells bounced back so well that I'm having my lumpectomy on Wednesday when they said I'd have to wait at least a month.
They say it'll be about 3 weeks before they put me on chemo version 2. The oncologist told me that the radiation is always last when you're having multiple types of treatment. She said that rads should start about a month after I finish with chemo version 2. However, it seems that it all changes depending on the individual situation. I'm hoping that because I'm younger (36) they can shorten up the wait times for me and get me done sooner. I guess I'll have to let you know as I go along.

These seem to disagree... (and apparently breaking up the scar tissue can be very painful). http://www.breastcancer.org/bey_tre_recon_Implnt.html
Scar tissue
Once a breast implant is in place, scar tissue forms all around it, forming what's called a tissue capsule. Most of the time, these tissue capsules are soft-to-firm, and unnoticeable. However, less than 15% of the time, a hard capsule forms that can be painful and distort the breast. In these cases, a surgeon can break up the scar tissue and, if necessary, replace the implant.

If you have radiation therapy to the breast area, the risk of scar tissue and hardening around the breast implant increases to 40–50%.

Massage and exercises may reduce the risk of forming a hard capsule (with or without radiation). You can ask your surgeon to show you how to massage the implant and the area around it, firmly but gently.

Shifting, leaking
An implant has a small risk of riding up the chest, so you may have to massage it down into place.

Occasionally, implants leak fluid. The chance of your breast implant leaking increases over time. Most implants that have been in place for 10–15 years have some leakage, but it's usually insignificant.

You may be able to tell if your implant leaks, because your breast may get smaller.
A small leak of a saline implant can't be detected. Leaking saline is harmless.

Even a small leak of a silicone implant can show up on an MRI (magnetic resonance imaging) scan, or sometimes on a regular X-ray. While this isn't necessarily dangerous, it can lead to complications that you'd rather avoid. If you suspect a silicone implant is leaking, have it checked and, if necessary, replaced.
http://www.breasthealth.com.au/careafter/implants.html
What are the disadvantages of breast reconstruction using an implant?

The disadvantages of having a breast reconstruction using an implant (over other types of reconstruction) include:

The breast may not be as ‘lifelike’ or natural as other types of breast reconstruction
In some cases, a capsule of thick scar tissue forms around the implant – this can make the breast feel firm and uncomfortable
The implant may have to be replaced at a later time
You may get an infection and the implant may need to be removed
If you have radiotherapy after having an implant, there is a risk that the tissue around the implant could become harder.

Would a reconstruction delay chemo or radiation longer than just a mastectomy would?

I don't believe our local system will delay me with waits.

Tomorrow I will be doing the 6th cycle of FEC chemo, and probably the last, neoadjuvant treatment for local advanced bc (multifocal, both invasive intraductal and DCIS).

I'm just concerned that with a reconstruction that they wait longer than they would for just a mastectomy. I'm pretty sure I still want a reconstruction at the same time as it could take up to a year or longer to get it done due to long waiting lists.

a mastectomy would?

It depends on how quickly you heal. Chemotherapy tends to interfere with the healing process. Sometimes, if there are still cancer cells there, those cells can result cause a delay in healing as well. Although one can still heal quickly and still have remaining microscopic cells.

<< Tomorrow I will be doing the 6th cycle of FEC chemo, and probably the last, neoadjuvant treatment for local advanced bc (multifocal, both invasive intraductal and DCIS).>>

I didn't recall that your cancer was locally advanced. I guess it is better that you did have chemo first. However, it would also be important to know if the chemo 'worked.' Sometimes PET scans can show whether or not the chemo was effective, but I think you need to have a baseline done first.

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Have you checked with another dr. for a 2nd opinion? What is most important to you--waking up from mastectomy having another breast or the chance of reducing risk of recurrence? There is really no way at this time to predict whether or not the neoadjuvent chemo was completely successful or who will get recurrence.
Your chances are less following treatment, but there are no guarantees.
Statistically, a woman generally has only a 1 out of 8 chance of getting breast cancer in the first place. However, except for most of the guys, the women on this group--about 90% or 9 out of 10 have had breast cancer. These stats don't have alot to do with your specific question--just sharing as reference to the overall concept.
Anne, you have to choose whatever you feel is best. Your oncologist gave his opinion based on his understanding of cancer and, perhaps, his own personal experience. Again, if at all possible you might want to consult with a second and even a third oncologist for other opinions and on what information those are based. Take care and wishing you all the best!

<< Can you tell me how long after surgery I might have to wait before starting chemo and radiation, if they're necessary.

It depends on where you were treated. I started chemo 4 weeks after surgery.
I have heard of some starting sooner.
I started rads 3 mos. after surgery. Generally speaking, if rads are needed I think it is best to do them no later than about 3 mos. after the surgery.

I think your oncologist has similar concerns.

I just reread all your posts, then checked the archives and the internet (on a number of issues/posters) in regards to your type of situation - late diagnosis, age, # tumours, what they're seeing in the lung, closeness to the chest wall).

I worry that your staging might change (for the worse) after the surgery or after the 3-month lung checkup . I worry that reconstruction will somehow interfere with giving you your best shot for survival. I could be wrong.... I'm just a layperson.

http://www.imaginis.com/breasthealth/ reconstruction.asp
Disadvantages to immediate breast reconstruction:

Patients may find it emotionally difficult to weigh all of their breast reconstruction options while also dealing with their recent breast cancer diagnosis and treatment alternatives.

If surgeons find that the cancer is more advanced than they initially thought, breast reconstruction may interfere with treatment (such as chemotherapy or radiation therapy).

Some doctors recommend that women who need radiation therapy after breast surgery have delayed breast reconstruction. Though radiation after the insertion saline implants or muscle flap procedures may potentially distort the breasts, this is rare. Radiation therapy can usually be administered to patients after breast reconstruction without any significant consequences