chemo or not

jbaudit

My wife is at the stage all you ladies were at a while back. First I want to wish you all great sucess with your treatment and hope the cancer will stop right in its tracks.

I have a question concerning chemo treatment as a necessity. reading all the comments from the wonderful women  who have supported one another I find it so encouraging that help is offered based on previous and current experiences

I Believe my wife has ILC stage 2 grade 2 with no lymph involvement and ER+ PR+ HER-

She had her lupmpectomy + sentinal node biopsy 6/26

i am wondering if any of you ladies had similar diagnoses and did chemo and why.

It seems to me that the lymph involvement and HER+ is more common to chemo treatment

I wish all of you a wonderful 4th of July weekend and  pray for all here to be well and beat this SOB disease.

MaryNY

jbaudit: your wife would be a candidate for the Oncotype DX test, since she is ER+ and node-negative. That would give her another tool to help in making this decision. A low score on the test suggests that chemo would be of little benefit, while a high score suggests a high reduction in risk of recurrence with chemo.

Has she made an appointment with an oncologist yet? It would be best if her case was reviewed by a good oncologist. He/she will take a number of factors into account in suggestion a treatment plan - tumor type/grade/stage, tumor hormone receptor status, age, menopausal status, family history of bc, prior medical history. 

NEODonna

OncotypeDX is the name of a test they do on the tumor tissue. It is used in early stage breast cancer to see if chemotherapy would be beneficial.  You can read about it at www.mytreatmentdecision.com.  Even if your wife's score is low enough to say "no chemo", because she is ER/PR+, she will still take a pill for 5 years. Which one depends on whether she is pre or post menopausal.

CoolBreeze

You are correct - now just about everyone with HER2+ cancers are offered chemo, even those with smaller ones.  The treatment for us is Herceptin, which works best in conjunction with chemo.  HER2+ cancers are very tricky, fast-growing and agressive.

In your wife's case, she may not need chemo.  Her cancer responds to estrogen and they will want to block estrogen, which means she will take tamoxifen or arimidex or femera or some other Aromatase Inhibiter for five years.  Tamox is for those who are pre-menopausal, AIs are for those who are post.

Others have mentioned the Oncotype DX score, and it's important that you ask your doctor for it for all the reasons mentioned above.  

The answer to your question is that many women do have the same cancer as your wife and don't have to do chemo.

Good luck to your wife, I wish her a full recovery.

LoveCranes

I'm ER+/PR+/Her- , lymph nodes clean, lumpectomy done on 6/21/10.  My breast surgeon mentioned to me that the only thing I would need is rad and tamoxifen.  After I met with the rad oncologist, she was surprised that I haven't met with an oncologist yet.  I made an appt with an oncologist and because of my type, size, history (no family history of bc), etc.... he suggested the Onco DX test... in order to make a decision about chemo.  If it's low, no chemo, if it's high then chemo...if it's in-between, then I'll need to make a decision -- .   I'm still waiting for my results. 

jbaudit

 lovecranes.

Thank you for taking the time to write. You women are so great in trying to help others. The info I posted may not have been clear My wife had her lumpectomy and sentinal node biopsy and what came was I think good news (No lymph involvement) After much pushing at the hospital I got the Patholgy and tissue report which tells me grade 2,stage 2, er+ pr+ ( 3+ with 75% involvement ) and clean margins 3cm in diameter. My wife is trying to avoid chemo and with this result it is questionable. We are seeing 2 Med onc 1 on  fri and 1 next thurs and 2 radiation onc one this thurs and one next thurs. My great concern now is the onco test takes two weeks to come back and its already two weeks since surgery. Can RADS be put off past 8 weeks after lumpectomy because  if we do chemo based on the Onco, that wont be decided for another 3 wks at best  and that puts us at 7 weeks + but we feel its important for 2nd opinions on both treatments and if she can get the onco, I would like to go that way.

I read  somewhere that there is a time constraint with radiation anyone with actual experience please chime in here

God bless you all

momand2kids

Hi

I had almost the exact same diagnosis-- 2cm, grade 2 stage 2 lobular, clear margins, no nodes.

I had my lumpectomy on November 25th--I got my oncotype results on January 7th..... that was fine-- I needed at least 4 weeks to heal.... I started chemo on 1/16, ended on 2/27 and started radiation about 3 weeks later.  

while you don't want to delay treatment, she does need time to heal-- and I am sure your doctor would tell you if he/she thought things should move more quickly--- I think getting the second opinions on treatment would be important.... for me, my oncotype results were in the "gray "area, which really makes the decision harder.... I finally decided that since I was pre-menopausal, had young children that I wanted to do it all now...... it was  a good decision for me and let me sleep at night..... 

 For what it is worth, I am over a year out of chemo/radiation and I am incredibly healthy---- I hope the exact same for your wife.... if I can be of anymore help, let me know

MaryNY

jb: If it has been two weeks since the Oncotype test was ordered, I would call Genomic directly and ask them when the results will be back. When I did that two weeks after I was told that my test was ordered, I found that my onc's office had messed up and the test hadn't even been ordered nor had the tissue samples gone out. When you call give them your wife's name and date of birth and they will tell you when they received the tissue sample and when the ordering physician can expect the result. If the test is complete, they will not give you the results directly. You must get them from the doctor. Genomic are great to deal with, very professional. Don't hesitate to call them.

It typically takes 10-14 calendar days to get the results, that's including weekends, so if yours was ordered when they told you it was, it should be back now. It would be good to have the result before your next appt on Friday.

Genomic Health - Tel: +1 (866) ONCOTYPE (866-662-6897) 

thegoodfight

Please do not fret over a time constraints issue.  You can see my diagnosis in my signature line below.  I had my lumpectomy in July of '08.  I didn't come to the decision and start chemo until October '08 and after completing that in January, I started radiation about three weeks later.  You have time.  Wait for the oncotype results.  Mine was 17, but because I was grade 3 I finally decided to go forward with chemo.  For me that was the right decision.  I couldn't live with wondering if I "should" have.  The chemo by the way was very doable.  Good luck in making your decisions.  The answers will seem clear in time.

Caren

Shelly1953

I'm ILC also (see my dx).  I'm not trying to sway an opinion, just tell you mine.  I did not want chemo, cried when I found out I was going to have it.  Had a rough time with it.  But you know what?  When I was sick with each chemo I felt the chemo was REALLY working.  Now that chemo is done (TCH x 6) on April 8th.  I'm so glad I did it.  ILC takes a long time to grow and tricky to find.  I felt if anything was starting in the other breast, the chemo would zap it.  I wanted to do everything possible so I don't have to do this again!  Still having treatments every 3 weeks- herceptin.  Started Tomoxifen a couple of days ago.  My feeling is if I get cancer again (heaven forbid) I want to know it's not anything I DIDN'T do to fight it.

This is just my outlook.  You have to do what's right for you and your wife.

Good Luck,

Shelly