Chemo v No Chemo... That's the question

Kelly29withbreastca

Hi,

I just joined this forum today... I am 29, diagnosed with Invasive Ductal Ca, tubular features, in Feb '09, underwent bilat mastectomies March '09, and currently have expanders. Negative nodes (0/9). My tumor was small, 1.2cm. ER/PR +, Her-.

My question is... All the features of my cancer including size, pathology, nodes, and hormone status are all favorable... a very non-aggressive ca. The problem is, my age. Because of my being so young, my oncologist sits on the fence of whether or not I will benefit or be harmed by chemo. The two thoughts are:

1) There are so many potential years for this ca to recur, I should take Chemo now to decrease the risk of recurrence down the road seeing that this type of ca usually recurs later rather than sooner.

VS

2) There are so many years to live, I would be at higher risk to develop Leukemia, which is a potential late s/e of Chemo. So why expose myself to a second type of ca if the breast cancer I have now is so non-aggressive.

Anyone out there in my situation? You have a small, node negative, tubular cancer who is young, trying to decide if the benefits of chemo outweigh the risks? I have to make a final decision by June 1st...

 Thanks for your help.

Kelly

lexislove

Even though your tumor is a "good " cancer..... its cancer. I was diagnosed at 30. Granted..I HAD to get chemo first to shrink the tumor so it could be removed succesfully. BUT...I also think about what if, my doctor at the time had not misdiagnosed me and sent me for tests right away. When I first found my tumor it was the size of an almond. So I may or may not have been where you are now. But in hindesight...I still would have wanted to do anything to help my risk of the BC coming back.

The risk of leukemia is like 1%, I have even heard as low as .8%. I wouldn't worry too much about that.

Was your cancer graded a 3? Then that would be an agressive growing BC.Most woman, and young woman at that, the cancer is grade 3. Young woman and BC is a different ball game compared to someone who is 50 or older. It has been proven that BC in younger woman is naturally more agressive in general.

You have already been agressive with the bilateral mastectomies and you will most likely be on some anti hormone medication for 5 years since you are ER+. I'm sure that your onc might only perscribe 4 sessions of chemo, 6 the max. It is doable. Boy..oh boy I had 8 session, 6 months worth...lol. You would probably be able to skip on the radiation..thats good.

Bottom line my opinion, I can sleep better at night knowing I have done everything to keep this away. If I had to do 16 chemos ..I would have. Again, your tumor is small, nodes are negative, but if you read through some ladies stories on here...that really means nothing. Cancer cells can escape through the blood too. There are many woman on here who have had "good" cancers and are now Stage 4 metastatic / not curable but treatable. this is just my opinion of course, I'm sure other young woman will give their opinion.

Food for thought...be well.

BTW..I'll be 32 next month (dx right at 30)

S.

nash

Did they run Oncotype on your tumor? That can help with the chemo decision--it measures how hormone resonsive your tumor is (and therefore how sensitive to either hormone therapy or chemo your tumor will be), and your risk of recurrence. You can read more about it at www.oncotypedx.com

Chemo isn't necessarily more effective than hormone therapy--it just works better on some types of tumors, and that's where the Oncotype test helps.

You may also want to check out www.youngsurvival.org. 

Kelly29withbreastca

Thanks ladies,

I had the Oncotype testing done... my score was 14, which is in the upper end of the low range. That is another part of my case that makes the decision so difficult. Ordinarily, folks with a low oncotype score (17 or lower) would only be treated with hormonal therapy... but new data found in the most recent clinical trial, TailorX, is showing a slight benefit with chemo if your score is 11 or above. So, we are back in the same boat, what to do?

 Kelly

nash

Has your onc run the benefit percentages for you? I was told to do chemo only if there was a 4% benefit or greater. Not sure what the % benefit for a 14 is.