Should I do chemo?

Theresag

Should I do chemo?

Theresag

Recently diagnosed with invasive ductal carcinoma. Had a lumpectomy. Tumor was 1cm, no node involvement, tested positive for both estrogen and progesterone, HER2 negative. But the tumor was a Grade 3. Going to do radiation and hormone therapy. Oncologist says that gives me a 82% chance of no recurrence over the next 10 years. Don't know whether I should do chemo. Oncologist says it would (at most) raise me to 86%. Haven't gotten my Oncotype test results yet. Should I do chemo?

Anonymous

Theresa,

mine was 2.4 cm, no nodes, grade 1, er/pr+, her2 neg...my onco score was 12.....no chemo for me...but am doing the hormone treatment after having a complete hysterectomy to lower my estrogen levels as much as possible.

You are the only one that can make the decision to do or not to do chemo....are you comfortable with the percentages your onco gave you?? I would say if mine had been grade 3 I would have seriously thought further into doing chemo as that is a more agressive cancer and I see alot of ladies here do it for grade 3.....

How much longer before you expect your onco test results? Maybe that will give you some insight on which way to go....

Best Wishes

Jule

NancyD

If you have time to wait for your oncotype score, I would wait.  If not, you have to weigh the tx plan against the possible longterm side effects. What drugs are they proposing? Do you have any pre-exposure to possible carginogenic triggers like benzene?  Is your heart is good shape...could it stand some deterioration from the drugs? Research the drugs and compare the possible se's to your history.

For me, the question wasn't should I take chemo to get the extra 4%...it was what can I do to get 1% here, 2% there on top of it...I would take/do anything that gave me a slight edge. Chemo was a given.

I felt pretty good about my physcial state before I started chemo. I'm about 1/3 of the way through and the most significant physical change/side effect is the loss of hair. Of course, the long term se's are an unknown as yet, but if they do develop I will take the intervening years as a gift of the TAC, not that it robbed me, for without the chemo, I surely would NOT have them.

ritajean

Hi there!

My tumor was 1.4 cm., IDC, stage 1, no lymph node involvement, grade 3.  I had a lumpectomy.  My oncologist suggested that I do CMF chemo.  This is a lighter chemo.  Instead of the 4 AC treatments, you take 6 CMF and for early stage IDC the treatments are comparable in affectiveness to the 4 AC.  You do not lose you hair.  It thins some but usually only you and your beautician know.  It is much easier on the heart.  You may want to talk to you onc about CMF and see what he/she says.  It is very doable and I wanted to do whatever I could to keep the beast away.  I knew that I would always wonder if it came back and I hadn't done the chemo.  I also did the 33 radiation treatments.  I finished them all last August and so far, everything has been good.  There is a CMF question thread that you might want to browse through under the Help Me Make it Through Treatment section and some of the gals are currently going through CMF.  It might help you to formulate some questions for your onc.  The reason that my onc thought that I should do the chemo was the Grade 3 rating, which means that the cancer was fairly aggressive.  He felt we needed to respond a bit more aggressively than with just the rads. 

Now I am taking Arimidex.

Only you can make this decision.  I wish you the best.  This is the toughest time, no matter what you decide.  It is so hard to know what to do and we must be happy with our decisions once they are made.  Good luck to you.  Please let us know what you decide.

Rita

jude14

I was a stage one grade three with tumor of 1.5 cm.  I was er/pr positive her2 negative.  No lymph nodes and clean margins on the lumpectomy.  I opted out of the chemo and did the radiation and taking the femara.  My onco dx score was an 18.  I am not sorry I did not do the chemo as the side effects of that were enough to make me think long and hard.  My doctors are keeping a close eye on me and if it were to come back then hopefully it would be caught in time to do something then.  I know several people who were similar to mine and did the chemo and it still came back with in a few years so I researched and all and decided no to the chemo.

AnnNYC

You've already gotten a lot of good advice here.  Because I had an oncotype score of 16 and was Grade 2 (not 3), I didn't choose chemo, which I'm happy about.  But I also think your age is another big factor in the decision.  I was 54 (now 55) -- if I had been under 50, ten-year recurrence chances would have had a very definite sound to me. 

EDIT:  Oops -- I typed "definite" when I meant different!  If I had been under the age of 50, the talk of "risk of recurrence in 10 years" would DEFINITELY have had a very DIFFERENT sound to me.

lilwebb

Hi, you and I have almost the exact diagnosis! I will hopefully know my oncotype score by Friday.When are you expecting yours? I am not sure if the SE's of chemo are worth possibly reducing the risk of recurrance by under 5%. I am 42, premenopausal, so that is also a factor. I am calling my onc tomorrrow to see if the results came in. Quite honestly, I'm more afraid of the chemo. than anything else. Keep in touch, and let us know how you're doing.

Good luck and god bless

Kim

Kfalls

My diagnosis was almost exactly the same as yours. My Oncotype score was 19 (low intermediate range). I am 49 - opted for 4 rounds of TC - fewer side effects than AC. It was a very hard decision to make but with three teenagers, I want to do everything I possibly can now, rather than regret it later. I think that it being grade 3 also made me lean toward this decision. My first treatment is in the morning. Whatever decision you make will be the right one for you, so listen to everyone else, but go with your gut. Karen

otter

Theresag, wait for your Oncotype results.  That will give you one more bit of information to factor into your decision.

These days, it is really hard for an oncologist to predict the risk of recurrence for a node-negative, Stage I tumor that is ER+ and HER2 neg.  The grade is certainly important, but the Oncotype score will provide a clearer indication of the aggressiveness of the tumor than you have so far.

My Oncotype score was 26, which was higher than I expected it would be, considering how long my lump had been there without an increase in size.  That Oncotype score corresponds to a risk of recurrence = 17%.  My onco said chemo would reduce that risk by 1/3, giving me a risk of recurrence of around 12%.  For me, that was enough to warrant chemo...but just barely.

Maybe your Oncotype score will be really low, and you won't have to worry.

otter 

lilwebb

Hi everyone,

I don't post often, but just got my onco score of 23. Could it have been any more in the middle or what!! I am part of the Tailor X trial, so I will wait (once again) till next week to see if I'm assigned chemo or not. Does anyone think I am crazy if I opt out of chemo? My kids are young, not yet teens, and I don't want them to be scared. Heck, I'm scared, but I fear the chemo more than the 5% chance it gives me. I know many will disagree with me. Please help, as I go back and forth with the pros and cons of my decision. You are all very strong women here, but I'm not sure I can do this.

Kim

otter

Kim/lilwebb,

No, you're not crazy if you opt out of chemo.  It is so tough to have these choices to make!  OTOH, I don't know if we would be much happier, if our docs made all the choices for us.  That's one reason why I fired my first onco--he didn't want to discuss anything with me.  He just said when the time was right, he would give me his recommendation.

As I mentioned, my Oncotype score was 26, and chemo doesn't give me much improvement in my risk of recurrence.  At least, it's not the improvement I would have liked.  Five percent is even slightly less.  Gosh, I just don't know what to suggest.  My mental cutoff for chemo/no chemo was a score of around 25, but that was probably plus or minus a few points if I was going to be honest.

Some women go all-out and fight for that last 1 or 2% of risk reduction, but I wouldn't have done that.  Chemo itself has risks, like heart damage and leukemia and neuropathy. The risk of those long-term complications is low, but it can be a few percentage points. The "discomfort" of the immediate SE's of chemo did not discourage me.  Those really are "do-able"; it's the long-term, possibly permanent damage that I was worried about.

OTOH, a BC recurrence sure can be a permanent problem.  Try the what-if game:  How would you feel if your coin-flip ended up "no chemo"?  Then, what if it came up "chemo"?  Which makes you more comfortable (or uncomfortable)?  Sometimes that's the only way I can make decisions.

otter (feeling your pain!) 

Urbie

My score was 15 and chemo changed my recurrence rate from 9% to 6% - and at the end of the day, I wanted that 3%.  It was worth it to me.  I did four tx of Taxotere/Cytoxan and the only side effect that I have suffered is trouble wearing contact lenses - still four months after my last tx.  But, I have no regrets and glad I did it.  I would wait for the score before making any decisions.  Good luck!

mary6204

My score was 17 and one of the many doctors I talked to was a woman from University of Michigan hospital.  She said if it were her, she would definitely do chemo.

Wednesday I wasn't feeling very good from my last treatment, but I forced myself to go to Curves.  I ran into an old neighbor and because I was wearing a scarf it wasn't hard to figure things out so I told her what was going on.  I had no idea, but she told me she got breast cancer at age 26 with a 5 month old baby and a 3 year old.  She went through chemo, was sick a lot, but is glad she did it.  Her mother got breast cancer and died from it.  Her sister got it twice and elected not to go through chemo the first time; the second time she had no choice.  My neighbor's doctor told her at her last visit, it was very fortunately that she was treated so aggressively, because he's sure that is why she is a 30 yr. Breast Cancer Survivor.  That gave me what I needed  to realize I am doing the right thing.

It's a not easy and some days I want to quit, but I won't and my family won't let me.  I look forward to when I get back to normal a few days after my treatment and I'm going  that time right now.  I'm 1/3 of the way through and looking forward to the end.  Good luck on your decision and God Bless, Mary