Will chemo be recommended?

Kate2z80

I'm not seeing the oncologist until Wednesday, my surgeon is away and I just received a copy of my pathology report (surgeon had previously called me with the results, but did not mention that "lymphatic invasion" was found; she is now on vacation).  I can be better mentally prepared for the recommendation of chemo if I have some thoughts on whether it is likely/probable/possible before my appointment.

I had a mastectomy with level 1 axillary dissection and the pathology report states:

Grade 2 IDC 1cm with clean margins

Nuclear grade 2 DCIS with three subtypes:  comedo necrosis, solid and cribriform

"Lymphatic invasion is identified" (this one scares me the most)

 Axillary lymph nodes are negative (0/5)

Grade 2 IDC with DCIS

AJCC: "pT1bpN0"  (I don't know what the "p" is for [primary tumor?] or the "bp", but I do know what the other things mean)

 I would much rather know in advance what is on the table as far as adjuvant therapy and would appreciate any input you have.

BTW, I don't have the oncotype test results yet.

JanMarch

Hi Kate, since you are Stage 1, node negative and ER+, I would encourage you to get the Oncotype Dx test done (if you haven't already).  This will give you and your onc a better idea if chemo will be beneficial to you.  I had a similar pathology to yours and my Oncotype score was low, so my onc didn't recommend chemo.  I'm taking tamoxifen, which hasn't been bad at all. 

Hugs to you!

dlb823

Hi, Kate ~  It sounds like you're a good candidate for the Oncotype-DX test, which will quantify the benefit of chemo to you by analyzing tissue from your tumor and giving you a score that correlates to potential recurrence rate.  You can read more about it in the information section (bar at very top) of this site.    Deanna

Kate2z80

Thank you both.  I just updated my post.  I don't have the oncotype results yet, but hope the oncologist will have them on Wednesday.  Not sure, though, since my surgery was just 2-1/2 weeks ago.

Kate2z80

Just found more info on this website:  "Chemotherapy is usually recommended for pre-menopausal women if the tumor is invasive, has not spread to the lymph nodes, and is one centimeter or more in size."  Shoot.

JanMarch

I also thought I'd be getting chemo based on the info from this website that you quoted.  I am 42 (pre-men), my tumor was 1.7 cm and invasive.  I was all prepared for chemo, but my Oncotype score came back in the low category.  I went to 2 oncs to be sure that I wouldn't need chemo and they both assured me that chemo wouldn't benefit me at all.  So, maybe you'll get the same great news!!  Good luck and keep us posted!

yasminv1

I too am wondering if chemo will be recommended for me. I am only 31 years old and have read a few articles stating chemo is recommended for women 35 and under?

Here is one of the articles: http://www.sciencedaily.com/releases/2009/03/090304144302.htm

Does anyone know if age truly is huge factor in determining additional treatment? My breast surgeon thinks I will only need tamoxifen but after reading articles like the ones above, I worry tamoxifen might not be enough. I am definitely going to request the Oncotype test when I finally meet with the oncologist. I had 2 small tumors with less than 1cm invasion in addition to extensive DCIS and one other small tumor that was mucinous carcinoma. My Bilat MX came back with positive margins on the left side. I had a re-excision and BS said path report says no additional cancer found on the tiny bit of tissue they took.  I am not sure if they were completely clear or close margins. I will find out Wed. when I see him. Luckily my nodes were negative.