To do chemo or not w/ 2nd breast cancer?

brst26

I was first diagnosed w/ IDC (2cm, triple negative, BRCA1+) in 2007...did neoadjuvant chemotherapy, lumpectomy & axillary lymph node dissection, and finished up w/ radiation. All my MRI's & Mamm's have been good until January (2012). MRI showed a suspicious nodule that wasn't there 6 months prior in the opposite breast this time. Biopsy came back as DCIS (5mm).Had lumpectomy in February & pathology from surgery came back IDC in my margin (5mm).



I decided to have bilateral mastectomies due to the fact I've had 2 primary cancers and I'm only 31. Pathology from mastectomies showed no residual cancer in either breast tissue nor my lymph nodes (2 sentinel nodes were removed).



It was only recommended that I consider chemo based on my age, but there is no evidence it is beneficial in terms of tumor size being so tiny, no lymph node involvement, and having bilateral mastectomies. I really don't know how to choose! Having gone through chemo before, I don't want to over treat this with unnecessary and potentially useless chemo. Any recommendations?

Karen3

Hi brst26

I was in a similar situation to you - diagnosed with DCIS (mine was 4cm) in opposite breast after IDC TN tumour in other breast (I am also BRCA1 but of unknown signicance). Fortunately, I did not have any invasion so chemo was not suggested. I know what you are saying about the fact it is only tiny etc and lymph nodes are clear BUT please note that there are ladies on this board who are stage IV and who started off as node negative. I do know that TN cancer is 'sneeky' as is Her2 + cancers. Mine was even invisible to mammos and ultrasounds! Circulating Tumour Cells (CTC's) can also invade the body via blood. I think you need to weigh up the costs and benefits to you. I had already made the decision that if there was ANY invasive element then I would have chemo again (even though chemo didn't work for me first time round as neo adjuvant showed nil response - but I am assured there are other chemo options now). I am not sure if this helps but I wish you all the best in your decision.

burge

Hi, Had BC 2005 (triple neg/braca1/nodes clear) also has lumpectomy w/chem & rad.  BC 2011/0.5mm / BMX/nodes clear/. I opted for no further treatment -  no chemo or rad.  Just reconstruction.   My surgeon & PS believe I choose correctly. My oncologist said that they are re-evaluating the over use of chemo and went along w/my decision.  I don't see him anymore, just my 2 surgeons and my gyne.  If it comes back-well I'll deal with it then.  Good luck.

brst26

Thank you both! I have decided to decline chemo because I just don't feel it is necessary.