Dx: MIcro-invasive DCIS..0.2cm ..triple negative

KMccoy

Hello I was hoping to get some information as to what route I should take. I was dx with IDC with 0.2cm invasion. Im 37 years old with a 5 year old. My oncologist stated that since the tumor was so small, he did not recommend any chemo. However my surgeon stated that since I'm so young he wants me to have chemo. I have read where some people with a small tumor such as mine has had chemo but they were ER/PR positive or HER2 positive. My pathology shows that I am neither. I am what they call triple negative b/c of no positive receptors. Right now I'm not sure what to do. I would think the oncologist would know whats best, but I want to do the right thing that will better my chances of not having a reoccurrence in the long run. HELP!!!!!

Beesie

KMccoy,

With triple negative tumors, because hormone therapy such as Tamoxifen or the AIs isn't appropriate, often chemo is recommended for quite small tumors.  But honestly, in 6 1/2 years hanging out here, I can't recall ever hearing about someone with a 2mm triple negative tumor getting chemo.

Current treatment standards suggest that chemo should be considered for triple negative tumors that larger than 5mm, and should definitely be given for tumors that are larger than 1cm.  See page 71 of the NCCN Patient Guidelines for Breast Cancer. These are the treatment standards that most oncologists in North America use as their guide.

NCCN Guidelines for Patients, Breast Cancer

My suggestion is that ask your surgeon how his recommendation fits with current treatment standards.  Find out what he feels your recurrence risk is if you don't have chemo, and how much it will be reduced if you have chemo.  That will tell you how much benefit you will get from chemo. Get your oncologist's opinion on that too. And keep in mind that a surgeon's job is surgery, while the role of the oncologist is to consider what other treatments may be required.  So it's your oncologist who is the 'expert' when it comes to chemo, not your surgeon. 

You might also want to look at Cancermath.net.  Breast Cancer Treatment Outcome Calculator   When I input the data you provided, it appears that over 15 years, chemo benefits 1 woman out of 100.  (I find the Pictogram display to be the easiest to interpret.)

I hope this helps! 

Sugar77

Hi KMccoy, my tumour was also very small (3.5mm) and triple negative. My oncologist recommended I do chemo and due to my age (45 at the time) and the fact I was otherwise very healthy, I went ahead with it. It's no picnic but it wasn't as bad as I envisioned. Looking back, I have no regrets and am very glad I did the chemo.  There's a thread for TN women and the vast majority of women with this type do chemo...even with small tumours. Good luck with your decision and don't hesitate to send me a Private Message if you have any questions.

Beesie

Sugar, thanks for jumping in.  And I should clarify for KMccoy that while I can't recall anyone with a 2mm triple negative tumor getting chemo, I do recall some who've had 3mm or 4mm tumors who've had chemo.  So it's definitely a very fine line!

KMccoy

Thank you all for your posts. I will definitely ask the questions that you posted above Bessie. Thank you sugar77. I know I can do the chemo if needed.

Thank you both. I will keep you posted on the final decision.