Should I wait or not?​ hormone vs. surgery

Emmaxx

I was diagnosed with breast cancer two weeks ago.The size of the tumor is 2.1cm, with a low combined histological grade, low proliferative rate, ER strong expression in approximately 100% of neoplastic nuclei, PR moderate expression in about 90% of neoplastic nuclei, and Her-2 negative.My doctor put me on hormone therapy (Tamoxifine) first for 3 months and then performs surgery, hoping to shrink the tumor so that lumpectomy (partial mastectomy) can be done followed by radiation therapy,instead of full mastectomy.So my question is: should I wait or not?

Fe_Princess

Hi Emmaxx, sorry to hear about your diagnosis...The decision is up to you, but if you went ahead with the mastectomy would you need radiation or just with the lumpectomy?

jc254

Since you don't seem comfortable with your doctor's recommendation, a second opinion might help.

Emmaxx

Mastectomy, may plus radiation.

Holeinone

Emmaxx,

Sorry you are dealing with this, not easy. The decisions in the beginning are overwhelming. I did not find this website until I was at the end of chemo.

Weekends can be slow, someone will come along & post with good advice/perspective.

My tumor was small, the Cancer in my axillary ( armpit ) was huge. I was glad they did surgery ASAP, because the nodes had become huge tumors. ( I did not have any clue about this before surgery ). Because the tumor was small ( the primary tumor in my Breast ) my lumpectomy was fairly easy, looks good. The one thing that I have learned being on this website for 18 months is reconstruction can be a nightmare. Not always, of course, but much more difficult than a lumpie.

The good thing about waiting is you will know if the Tamoxifien is effective. Sounds like it was caught early, & has not spread. I decided in the first week to go with my Drs. advice, I was pretty clueless and my surgeon & personal Dr. are people I know in my smallish community. My dx was/is scary. The emotional aspect is as difficult as the stinkin chemo. Good luck....

ruthbru

I, myself, would try the hormones first. Of course there is no guarantee, but with such high ER & PR counts, your stats should make you a perfect candidate for them to work well. Low proliferative rate means it's slow growing, which gives you more time to make decisions. A full mastectomy is a major surgery with a long recovery time & if you choose reconstruction, you most like will have multiple surgeries before you are 'done'; you will really want to think about how you feel about the physical and physiological aspects of going down that road if you don't have to. Another lady on the boards has made up a non-biased list of considerations for women considering a mastectomy vs a lumpectomy. I can post it if you want to take a look at it. And, second opinions are always appropriate if you feel uneasy about your treatment plan.

Hopeful82014

Emmaxx, I did 6 months neoadjuvant Femara to bring down proliferation rate and see if we could clear my malignant node. The situation is similar, but not exactly the same, as what your doctor is proposing. I have surgery next week and will find out then how successful we were with the node. Allthe signs are promising, however, and we do know that the proliferation rate dropped like a stone.

This approach has been used a lot in other countries but is new-ish to the US. The big advantage in addition to shrinking your tumor is that you would KNOW for a fact how your cancer responds to tamoxifen. That will be a huge advantage for you in the future.

I would strongly consider following your doctor's plan. If you're uncertain, talk it over in more detail with her/him.

Emmaxx

Thank you all so much for your input. I feel much better now. My main concern is if my lymph node is negative it may turn positive three months later. However, this is a question nobody can answer, even the doctor. I also heard that after biopsy, the damage and heal process will trigger the cancer cell to move out, is that correct? My last question is whether or not I should stop drink milk or begin to drink organic milk?

ruthbru

It shouldn't spread to the lymph nodes when you are on therapy (and if it did, then you would know that tamoxifin isn't effective for you  and you will be able to try another approach.....not take something for 5 years that is not doing it's job......so knowing if it is working is a good thing either way). No, a biopsy won't spread cancer. I just drink regular milk and don't worry about it, so can not answer that question.

tjh

I never considered lumpectomy, I just wanted the cancer gone. I also did not want radiation, since I have many moles and a family history of melanoma. I talked to my surgeons, PS, dematologist, and primary dr. All agreed mastectomy was the best couse. Min is currently being HER 2, FISH AND ONCO DX tested to check needfor hormone therapy or chemo. I am praying no chemo.