Invasive ductile carcinoma chemo/no chemo?

Clearbluesky

Hi ladies I am 67 years old. My tumor was 2.5 cm in size. I had a lumpectomy. One sentinel node came back positive with a 3 mm metastasis. Then I had an auxiliary node dissection - all 18 were negative. My oncotype score is 16 ... should I do chemo or not?

BikerLee

Despite having one positive node, your low oncotype score seems to suggest no benefit to be gained from doing chemo...  BUT - I'm no medical professional!

Talk to your health care team about your results and any other details of your pathology report... Keep asking questions until you feel PEACE around chemo or no chemo.

Honestly - don't do chemo is you're unlikely to receive benefit from it. But, DO chemo is you're likely to benefit from it.  Your health care team should be able to guide you towards the right decision for you.

I hope that helps...

edwards750

Clearblue...agree with Biker. I think an Oncotype score of 16 is still considered a low score. I believe 18 puts you in the intermediate category. I too had a lumpectomy and 33 RADS treatments. I had a micromet in my SN. My ONC ordered the Oncotype test because she was unsure what treatment plan I should have. My score came back 11. No chemo. I would definitely talk to my ONC if I was you and then make the call. It all comes down to how much benefit you would get from it; as in benefit vs all the SEs. Good luck. Diane

Golden_Gurl

Hi Clearbluesky, I also agree with BikerLee. What grade was your tumor? That is another thing that they take into consideration on the chemo no chemo question. I am so sorry you find yourself in this quandry, it is not an easy one. I chose no chemo, oncotype 12, My onc does not believe in the oncotype or mammaprint tests, my surgeon is a breast cancer specialist, she is the one that ordered the tests for me. Needless to say these two are constantly at odds so I fired my onc. My surgeon prescribes my arimidex for me so I dont feel I even need an onc at this point. Don't be afraid to get second and even third opinions, however many it takes for you to feel comfortable with the right decision for you.

I am wondering if the oncs in my medical group are the only ones that "pooh pooh"( their exact words) the oncotype and mammaprint tests? They told me that they go strictly by the standard of medical care which includes chemo for everyone! When I tried to argue that the tests help weed out ones that dont need chemo I was met with hostility! That is when I said Adios non amigos!

aussieched

Golden Gurl,

We have a very similiar diagnosis, and I didn't do chemo either. Unfortunately here is Australia we were not offered the Oncotype back in 2007 so I have always been concerned that I didn't do chemo. The drs suggested that I have my ovaries ablated which I did. I often wonder whether I have made the right decision, but during the last few years, I have noticed more and more ladies on this board that haven't had chemo with 1 positive node, so hopefully it is now part of the treatment regime for some of us.

Ched

Sandymomto3

clear blue....my tumor was about 5cm total size. I had 3 positive nodes of 17 removed. My Oncotype DX test score is a 13. Probably also not having chemo. It just doesn't reduce my recourance rate enough to justify the side effects. My cancer is also er/pr+, there are lots of studies going on now about the 1-3 positive node group of ladies. Chemo despite what many think does not reduce our risk of recourance to zero. I would probably would have needed a 10% reduction rate to change my mind. Tough choices, but there is no need in shooting a fly with a bazooka. I will take radiation for 6 weeks, and then begin my hormone receptor blocking meds.

SewStrong

Absolutely, definitely, for sure do chemo. My tumor is Triple Negative and there is no 5-year pill to take to help it not recur, because there is no medication discovered for that yet. My tumor was 3/4 cm and my surgeon said no chemo. I made an appt. with a MO myself and he sent me to a MO who specializes in TNBC. She recommended the chemo and I took my 3rd of 4 yesterday. I am gaining peace of mind every day and the doctor said he's giving me a longer life because of it. TNBC needs chemo for sure no matter what the size, but with the positive kind, I think the cutoff for no chemo is 1 cm. Definitely go do it. It is very manageable if you eat right and take care of yourself. Take the meds for nausea and you won't get sick. Take the neulasta shot to bring back your white blood counts and you will get through it very nicely. The infusions are easy, the after effects get you sometimes, but they give you what to take for pain in the bones or whatever. It works fine. Have a positive attitude and pray a lot. Come to the forum called older Christian women with breast cancer (not sure if that's the exact name) We pray for one another. If you don't pray, we'll teach you. It's Jesus Christ so get ready for some blessings. Shron

SewStrong

Sandymomto3, I am only getting a 2 1/2 % benefit and I'm doing chemo. I have triple negative, a very aggressive form of BC, so my husband and I decided that I would rather have some life-long side effect because I would know I didn't die from it. If a cancer metastasizes, it is much worse and always a stage 4. I was scared not to do it myself. I'm 69 next month and what do I have to lose? I would rather have neuropathy than a gravestone. I hope I'm not sounding harsh. It's our lives we're talking about. If you are a person with severe allergies or other health issues, maybe chemo isn't for you, but for me, I am really pleased. I have one more to go. Hope this helps. Sharon

Sandymomto3

triple negatives for sure need much more aggressive treatment. They do not know as much about them as they do the er/pr + cancers. You do not sound harsh at all no worries. The clinical trial I'm participating in, is for hormone positive cancers only. One more node and I wouldn't have a choice. I am thankful for medical oncology doctors that are learning and treating the biology of cancer, not just the stage. Size alone makes me a stage 3, with or without node involvement. Prayer is a powerful thing, as is a positive attitude.

coraleliz

Clearbluesky hasn't checked in since Oct 4th, the day of her original post. I'm one of the positive node gals that didn't have chemo. I was 52 when diagnosed. I had 2 positive nodes(3mm). Oncotype of 4. The oncotype test is for ER+ tumors, so it would not apply to ER- tumors. Many of us responding are grade 1, which means well differientiated, & not likely to respond to chemo. It also means less likely to reoccur. Hope your finding answers to your questions.

RNangie

Clearbluesky: I chose to do chemo because I wanted to be able to look back and say I did everything possible to treat it. I am triple negative and am happy to say I finished 16 weeks of chemo in July. It's not easy by any means, but it can be done. I continued to work full time too. The timing of my chemo made for crappy weekends. Your cancer team can help you decide the right path to take. They can give you all of the statistics you want and some you don't )

Good luck and peace with deciding.

SewStrong: looks like we may have the same cancers and treatment. Hang in there for last chemo!

Does everyone get the Oncotype test? Not sure if I have.

Peace & Strength to you all! ~ Angie

SpecialK

Oncotype was designed for ER+, node negative. It is now being ordered by some docs for node positive patients.

gia444

I am doing chemo even with a 2 1/2 % benefit because I am triple negative. I might not of done it if I was positive. Even though it was only 1.5 cm with no node involvement. Triple negative is a more aggressive cancer.

RNangie

Hi gia444 - looks like we have same dx. I did chemo also because of triple neg. I have finished chemo and rad. Now just trying to get my energy back. Best wishes to you.

relocatedtarheel

RNangie- did you find the chemo manageable? I have my port going in tomorrow and my chemo starting 10/24. We triple negatives don't have many options :-) and we don't get onco testing, it is based on positive receptors.

relocatedtarheel

RNangie- did you find the chemo manageable? I have my port going in tomorrow and my chemo starting 10/24. We triple negatives don't have many options :-) and we don't get onco testing, it is based on positive receptors.

RNangie

Relocatedtarheel -

Hey. My chemo was manageable. I worked the whole time. I think I had to stay home about 4 days out of the 16 weeks. It's rough!! But going to work helped me because I didn't have time to think about "me"!

I would get my chemo on Thursday and my bad days would be on the w/e. It's sort of like a roller coaster - bad week, good week. Mine was AC for 4, then Taxol for 4.

Hope you did well getting your port today!

Michelle81

Hello,

I was recently diagnosed with TNBC. I have undergone a lumpectomy with negative nodes. Chemo and radiation have been suggested but I am havinng a hard time accepting the treatment. I will be looking for a second opinion but as I do my search online it seems like most individuals in my sitiuation have had to go through chemo.

I am trying everything in m power to remain hopefully and not overthink this.

Paulette23

hi my onco was 25.....they suggest chemo. ..tumor wad 2.1 after surgery. . aggressive. ....anyone who did chemo vs not....I am schudled to start wed....any

Paulette23

first opinion said no port second said port w no question! I have bad veins due to autoimmune pbms...slightky low kidney and liver...any thoughts...experience?

Gully

Paulette, I did four rounds of TC, my oncotype was 19, I am er pos but with LVI but neg nodes. My veins were really strong before chemo, and at age 45 active and healthy....before all of this anyway. I think the port would have been easier. I got really tired of being stuck. Its more than four needle sticks because of all the blood draws and shots. Good luck to you!

Paulette23

Thanks...prayers for u! I have bad veins from autoimmune pbms....have had piss lines and central lines in past....yahoo...now I get a port. I'm sure better than trying to find a good (none anymore) vein! My RN hubby agrees!

Terrican

I decided after four opinions to not do chemo. My oncotype score was 10. I am a little scared but would be scared regardless. I did a double mastectomy for a few reasons even though i was stage 1b. My mom died from breast cancer at age 59, my breast tissue is dense, my mammo missed it and i didnt want frequent surveillance and biopsies. The worse part so far was the LN dissection and those damn drains. If i can prevent going through that on the opposite side it was all worth it.

Now just trying to figure out tamoxifen and heavy periods. We are all amazing, fabulous, survivors. Let's beat this!

Paulette23

hold my hand! I've always been the one to give others hope......dropping in a hole....petrified.....

mmvh

Hi,

Clear Blue Sky, I have the same stats as you do, except I'm 53 now, 52 when diagnosed, 1 3mm lymph node, Er & PR+ no HER2, grade 2, stage II. I am IIA, ductal and lubular mixed.

what did you decide, Im trying to make that decision right now.

thanks, anyone else??

Paulette23

I'm gonna do chemo. ....since I see othes with less are doing.....had two MDs say the same...don't wanna but if those baby cells migrated...better safe than sorry....I really don't wannna..

LorenB

My Oncotype DX recurrence score was 16. But I was node positive (sentinel node) and it had broken through the node. So my Onco talked me into Chemo which I really wanted to avoid. I had an allergic reaction (minor) on my first treatment on Nov 1, 2013. So on my next treatment, Nov 22, they gave me a truckload more steroids prior to infusion. I had an even bigger reaction (serious pain down my spine) after receiving only 2cc of the stuff (taxotere was the problem) so my onco said I could no longer take that protocol and switched my to a 3 drug cocktail with 5FU Methotrexate and Cytoxin. My reaction to the 5FU at infusion was ok, but it was much harder when I got home. It's been 16 days and I am much worse off then I was 7 days after the taxotere. I won't be repeating this protocol. In fact, I won't be doing any more chemo at all. My onco said that it was a real possibility that when all these clinical trials come back we may likely find that I should never have had chemo. At this point it is my decision to discontinue it because I have not been able to handle the many difficult side effects I have had and at the same time be a wife or mother to my seven year old daughter. I will go in for radiation (6 weeks) and I will do the ovarian ablation and the hormone therapy thereafter, but this chemo is killing me. I'm not putting me, my husband or my daughter through any more of this. It is difficult to explain to friends and family why I have made this decision, but it is the only decision I feel I can make at this point.

Paulette23

be at peace with ur decision! that's the main point!

Paulette23

2 down two to go....fairing ok. worth the effort to drop stats by 1/

Paulette23

brw...PORT...YES!

ziggypop

Hey Paulette - Hang in there girl.. sounds like you have a great attitude about this, and while that can't cure the cancer, it sure can be a help in getting through the treatments.