Wife dx'd with early stage breast cancer at age 29. What to do?

SimonEf

Hey there,

So my wife was diagnosed with early stage 1 breast cancer. She is only 29 years old. The tumor was very small, so small that when they tried to do an oncotype dx test, the results were inconclusive because there wasn't enough cancerous material to test in the sample. From what i understand, the tumor was hormone receptor positive, HER2 negative.

The tumor was removed by lumpectomy, and the lymph nodes under her arm were checked and came back clear. On top of that, from what i understand the doctors told her that they had all of the 'edges' of the tumor, though i can't independently confirm this.

Right now there is a debate among the doctors at her hospital whether she should undergo heavy treatment such as radiation and chemo or not. The surgeon in particular is having all the data checked by another specialist at a different hospital to make sure there wasn't any human error in the diagnosis. When they removed the lump, at first they couldn't even find any cancer in it, they had to biopsy it before they supposedly found it.

I am not really sure what to do or advocate for. Because my wife is so young, it would be really rough for her to have to go through all sorts of chemo and ovary suppression and hormone therapy. Yet i don't want to suddenly in five years find out that the cancer has returned and with a vengeance. Has anyone else been in this situation? Did the fact that her lymph nodes are clear and the tumor removed essentially mean that she is "cancer-free" right now, and heavy radio/chemo therapy is more for future prevention than for immediate crisis? I know i don't have the entire dataset in front of me right now, but it's just...really hard to know what to do.

Heya24

Hi, so sorry to hear that. But on the positive side it's a good thing she got diagnosed early! The earlier, the better!

About chemo, to me it sounds like it's more of a just-in-case thing right now for her. Talk to her about how she feels and talk to her doctors, ask them every question you both have and write them down so you don't forget! Remember to ask about cancer reoccurence, what her risks are.

I recommend checking out the forum for family-members, caregivers, etc. You might find better info and support there!

I hope everything turns out ok. Good luck!

LM070917

So sorry to hear about your wife, although it's always horrible hearing of a diagnosis, it is very good to hear it hasn't progressed much.

As she is so young, I would be looking at potential risks that may have contributed to it, obviously her body must have been imbalanced in some way, I would reassess the potential risks- eg diet, smoking/alcohol, lack of exercise, stress etc? Once the risks have been reduced then she can work on getting her body better. The thing with conventional treatments is that they can be great for getting rid of the problem, but they don't really sort out the cause. Being so young, her body imbalance needs to be rectified and that in itself will assist against recurrence 😀

ShetlandPony

Hi, Simon. First, I must respectfully disagree with the above post by Lottemarine. To me it is not obvious that her body was imbalanced, or that lifestyle factors such as exercise and stress can account for your wife's cancer. Yes, lifestyle factors may contribute to risk and we want to do what we can, but there are many other factors that are as yet not understood, and also those that are out of our control. For example, there are random genetic mistakes in cells, inherited genetic predispositions, environmental factors we can't alter. Please don't blame the victim.

To answer your question, yes, any systemic therapy such as chemo or hormonal therapy would be for the future, to go after any possible rogue cancer cells anywhere in the body that might hang around and cause trouble later. The question they are trying to figure out is about the risk vs. benefit. Right now from what you have said, things sound good, and I suspect the doctors' biggest concerns are her age, and the fact that there is no Oncotype score to guide them. As far as breast radiation, it is standard with lumpectomy except in certain low-risk cases. It is done to prevent a local recurrence--in the breast. Although there is some evidence that it also may help prevent distant recurrence by zapping some of the lymph nodes, in case there are undetected cancer cells there. Has radiation been recommended to your wife?

Here is what I suggest:

1. Since your wife is so young and her doctors are debating, get a second opinion from a NCCN Cancer Center.

http://www.nccn.org/members/network.aspx

2. Ask if genetic testing would be appropriate. It can affect treatment decisions.

3. If you want to do some research to get more background, look at the results of the SOFT trial. It was about what kind of hormonal therapy to use for premenopausal women.

Simon, I'm sorry you and your wife are going through this. Just the fact that you are at her side holding her hand is huge, and will help her so much.