Chemo & Future Pregnancy- HELP

jhalvors

My father was DX with breast cancer 8 years ago. Even though we have no other family history of breast cancer in my family I wanted to be proactive as it is rare for men to have breast cancer. I had my baseline mammogram when I was 37 and was normal and was told not to come back till I turned 40. I turned 40 early this year and went for my second mammogram in March 2010. I received a call back for additional pictures of the Rt breast. Second set of films showed micro calcifications (80% chance of being nothing) and a subsequent BX showed (I was in the crappy 20%) 8 cm of DCIS in the Rt breast. Scary but 100% treatable and not life threatening. Had a lumpectomy in April 2010, and my world took a turn for the worst. Pathology showed 0.4mm of invasive grade 2, ER/PR +, HER - cancer with angiolymphatic invasion was reported present on path. Had genetic testing and was BRCA 1 normal BRCA 2 was "suspected deleterious", which meant although not 100% positive it should be treated as positive. In light of this I opted for a double mastectomy in early June just to be on the safe side and the pathology from this surgery showed to have no additional new invasive cancer since the April lumpectomy and the nodes were clean and negative. Had OncoDX test done and result was 21, which put me in the low end of the intermediate group (gray zone). Radiation was ruled out since double MX took care of the margins. Primary Oncologist is recommending 4 cycles of T/C due to the angiolymphatic invasion found on the path report in April. She said if that had not been present she would not recommend chemo as the tumor was so small. However, got 2nd opinion from a Oncologist at Stanford, and they said they could recommend chemo but would not push (as my primary oncologist seems to be doing) and they seem to be making this determination based upon tumor size even though angiolymphatic invasion was noted. Stanford also suggested Tamoxifan & Zoladex might be a good way for me to go instead of chemo, but my primary oncologist never suggested this. But of course Stanford said there is no right or wrong choice and it is ultimately my decision. That is what I am having a problem with. I don't have any children and was hoping to try this year (hence the check-up at my b-day) when all this was discovered. A fertility DR stated I have a 100% chance of going into early menopause if I do chemo, which is of course a major concern for me. If I already had kids the decision of chemo would already have been made. However, the reality is I dont and would still like to. So now what do I do. Tamoxifan is a given as both Oncology Drs seem to agree that the majority of reduction of reoccurrence (7%) will be from the hormone therapy. Meanwhile chemo would only offer and additional 3%. I would be interested in knowing if any women are in a similar situation as mine. I really and truly do not know how to decide. It seems if I do what my primary oncologist wants I will have to give up my dream of a child that is biologically mine, but if I don't do chemo and distant reoccurrence occurs down the line how do I reconcile that I didn't do all that I could when I had the chance. Is anyone going through this as well?