QUESTION: I noticed that you recommend no radiation therapy when one has lupus. Could you please cite the authority for your opinion? Thank you.
ANSWER: Lupus, an autoimmune disease that can affect the soft tissues, can be a relative contraindication for radiation. Scleroderma, another autoimmune disease, is an absolute contraindication to radiation—particularly in a setting where there is an alternative treatment option that is just as effective. What can happen is an exaggerated scarring and healing response to the inflammation caused by radiation. Sometimes, there can be too much scar tissue with a lot of associated stiffness and discomfort. If a lot of small blood vessels are affected by the lupus, then the tissues may not heal properly. However, it's also very possible that a woman with lupus would have no significant side effects with radiation. If there is a choice between lumpectomy/radiation and mastectomy, however, your doctor may recommend mastectomy just to avoid the potential extra side effects.
—Marisa Weiss, M.D.