Breast Cancer

marty71

Just had the lumpectomy - was cancer, very , very small, no lymph nodes was invaded.  Oncotype came back at 34! I have the tough decision - milder chemo or the more aggressive chemo plus radiation for both afterwards.  I cannot wrap my head around which one - leaning more towards the lesser treatment.  Anyone out there with same problem??

ChiSandy

Well, it’s a tough decision. Please make your profile (diagnosis, hormone receptor/HER2 status, grade, tumor size and cancer type--e.g., IDC, ILC, etc) public so folks here can weigh in on an informed basis rather than guessing. Did your surgeon get clean margins, and was there any lymphovascular invasion (your path report will mention that)? May I ask how old you are, if you have kids (and their ages), what you do for a living and if you have a support network of friends and family to get you through chemo? And speaking of which, what is the more aggressive chemo and what is the “lesser” one? Do you have any medical conditions that might be made worse, even life-threatening, if you get certain chemo drugs? How’s your immune system? Does your career depend on things that might be damaged (peripheral neuropathy, hearing loss) as side effects? All those factors need to be factored in to your choice. (Emphasis equally on “your” and “choice”).

Radiation is independent of chemo, as it’s to kill any tumor cells that might have broken off and escaped into your breast (but not your lymph nodes)--i.e., “local therapy,” while chemo is “systemic therapy,” to kill any tiny tumor cells throughout your body so small they weren’t visible in your nodes. (And if your tumor was hormone-positive, endocrine therapy is also “systemic”). It’s necessary after lumpectomy unless you are over 70 and/or your doctors don’t think it would be worth any risks.

When it comes down to it, it’s up to you, and your doctors should respect that.