Many questions, any help appreciated

Bonniebleu

Hi,

Here are some questions I have...

1) I originally was dx stage 2 via biopsy, but after BMX surgery the tumor was 19mm vs 20mm (2 cm). Can I really be 1mm between stage 1 & 2? This worries me a lot, for the same reason as #2

2) My Ki67 was 30% but my onco type was 13. The tumor is grade 2. These numbers give me the uncomfortable feeling that maybe I haven't done enough and should seek more treatment.

3) Is it common to have a ER + 95 and PR + 95 BC?

4) Am I cured or in remission?

5) After a BMX with SNB and nodes are there any weight restrictions on affected side

Family history of BC- mom, DX stage 3/4? AGE 68, mets to bone 5 years later.

Thank you so much! These past months have been such a blur and my brain is like a sieve. Plus I know the smart ladies here are on top of all this, can explain it better than any Dr. or book.

Molly50

Hello Bonniebleu,

First the difference between stage 1 and 2 is not huge. It's still early stage. I had a 2.1 cm tumor and two positive nodes and still am stage 2. If you are not satisfied with your oncotype Dx score you can ask your MO if you are eligible for the mammaprint. Your insurance company may not want to pay for it but it doesn't hurt to ask. You also can seek a second opinion on your treatment plan.

I do understand that unsettling feeling. I was originally told I would have chemo based on positive nodes but my oncotype was 13 like yours so chemo would only give me a tiny benefit vs risks from chemo.

My ER/PR percentage is high like yours which is good it means our cancer should respond well to hormonal therapy.

With breast cancer it's hard to say cured because you don't know who might recurr so it's best to say NED (no evidence of disease)

It is all very confusing and overwhelming. Hang in there.

Bonniebleu

Thank you Molly50 😊 I really appreciate your thoughts on this.

I'll find out more about the mamma print...it was never offered.

What about lifting or weight restrictions for the future? Or is that just for after surgery precautions

ChiSandy

Lifting restrictions will ease as you get further out from surgery, but it’s never a good idea to carry more than 5 lbs. (10, tops, and only for short periods) with your right arm--though you had only 2 nodes removed. You almost certainly would be skipping radiation since you had a mastectomy. With a node-negative, grade 2 and highly hormone+ tumor and OncotypeDX of 13 (the high degree of ER/PR+ plus a likely low mitotic rate outweigh the ki67 score, which is increasingly recognized as unreliable), it is highly likely that chemo would be more harmful than beneficial, even though you’re only 47. I assume you’re pre-or-peri-menopausal? If so, you’d probably go on Tamoxifen rather than an AI.

ER+ and PR+ both 95% is not uncommon, and is highly desirable. Tamoxifen (or AI + ovarian suppression) are very likely to work well. Chemo would not. You are not being undertreated.

Lunderwood

Bonniebleu,

I was diagnosed with stage 2 IDC in Nov. 2015 after finding a 2.1cm tumor in my right breast. I was 95% ER+ and 85%+ HER- I had a lower Ki67 score 8% and the tumor was grade 1. OncotypeDX was 17. I was treated for 6 months before surgery with hormone therapy (Arimidex and Fulvestrant injections) The tumor shrunk slightly but not enough to change the diagnosis to stage 1. I had a UMX in June and am continuing on with the hormone therapy. My medical team believes this is a treatment plan to reduce the risks of future recurrence. Unfortunately I believe that with hormone related breast cancer there will always be a risk of recurrence (even in the far future) so I am approaching it more from a mindset of having a chronic illness. I will continue to on hormone therapy and have also made lifestyle and dietary changes that will lessen the potential. You should definitely discuss your concerns with your doctors. They should be able to offer guide you on treatment plans for based on your reports.

I am 56 yrs old but very active. I resumed running (slowly) on my treadmill 2 weeks after my surgery. By 6 weeks post surgery I was back to running normal pace and distance. I followed a stretching program that my surgeons gave me after surgery and started lifting weights again at 4weeks. All weight lifting restrictions were removed at 6wks post surgery. I am now at 10weeks post surgery and have returned to almost all normal activities. I workout with hand weights and am also doing pushups. I am still doing the daily stretches and that seems to have helped greatly in my range of motion recovery. I am a bit cautious due to the tissue expander - I definitely don't want to do anything that will delay my exchange surgery at the end of September.

Good luck!!! Keep us posted on how you are doing!

Bonniebleu

chiSandy- yes, I'm premenopausal, so I've begun Tamoxifen and trying to get the dosage right for me. Thanks for info on lifting 😊

Lunderwood- thank you! You brought up something I've never even considered, that you're approaching this as a chronic illness, considering all that we do to try and ward off a recurrence that makes so much sense. It kind of makes it easier for me to think about it like that. Seems I have more control over this when I think of it that way.

Thank you so much gals!😊