Treatment plans for stage 2 grade 2 er/pr+ her2-

scaredashell07

please share your treatment plan for your stage 2 diagnosis and if you are cancer free. What worked and what you wish you had done differently (surgery, treatments, doctors and surgeons). I am being told I have stage 2 and should have chemo first. I got a different opinion and now have decided to do surgery first.

Cowgirl13

Hi Scared, I was stage IIA also. My treatment plan was the usual for HER2, which you are not. I was very lucky as I was happy with all my doctors and their treatment (lumpectomy, chemo, rads, and a hormonal). I am over 7 years out and still cancer free.

Question, who was it who gave you the advice re: chemo? Were they both oncologists? It sounds like the communication is difficult.

Waiting for your answer.

Liz

Alex276

I am also stage 2/grade 2, er+ pr+ her-. I had a double mastectomy 4 weeks after diagnosis. I had 4 tumors that were in 3 different quadrants so lumpectomy was not an option. Radiologist did not reccomend any radiation. My first oncologist reccomended 4 rounds of chemo just as a precaution. I got a second opinion from another oncologist and also talked to my radiologist who I absolutely adored and respected. They both said no chemo. The second oncologist actually took my case to the tumor board and all Dr's there agreed no chemo. So I decided to not do the chemo. I started tamoxifen in July but I have now decided to switch to ovary suppression with Zolodex and will start taking an AI if I tolerate the suppression. I will have my ovaries removed in a couple months, hoping to combine that procedure with my breast revision

scaredashell07

my surgeon is a surgical oncologist so it was both their opinions but they don't seem to treat the individual. They have a standard protocol for lymohnode positive status and that was why they recommended. On top of that I have said I have some concerns about other Breast and they said if I do a double mastectomy the first opjnion will not test the nodes for that breast whereas the other opinion said they would. So confused

Fe_Princess

Hi Scaredashell,

I have your exact diagnosis except my tumor was 3cm. I only had a bi-lateral mastectomy. I was told that if I had the surgery to remove the breast, I would be able to pass on chemo. I saw my oncologist after all the surgery was over and she told me that I was high risk for recurrence and that I should start chemo right away. I was like, WTF?! I had an oncotype dx test and my score was 15 which in the low zone. I moved to Switzerland in June of 2015, and my oncologist here told me I did not need chemo either. I have refused anti hormonal therapy (Tamoxifen) so my recurrence score goes up. I think you have to follow your instincts on this one. I am so sorry that you are in this place. We have to make so many life decisions so quick. If I could decide my treatment again, I would have kept my ovaries and would have taken my time on deciding what treatment to do. Do not let anyone bully you. Mastectomy is tough. Why are they telling you chemo before surgery?

scaredashell07

Hi fe princess. Thanks for your detailed response. they're telling me chemo because my lymph node biopsy was positive. And that chemo lowerrisk of lymphedema. I feel like I shouldn't question their treatment plan because they are MSk but I also don't feel that are telling me all my choices and all my risks

jojo9999

How many nodes were positive? If it is three or fewer, I would think you would be a candidate for Oncotype testing. What that mentioned in either of the opinions?

scaredashell07

this I is hnestly why I don't understand MSKs protocol. I feel like I'm a number and not an individual. I had one node positive found in an us and tested positive during needle aspiration. Also had an MRI but no oncotype test tHey said because I tested node positive I needed chemo anyway and oncotype didn't mater

edited- Ithey saw other nodes positive in MRI of the breast after biopsy.so a few on scan.

ThinkingPositive

scaredashell07... I had a node positive as well. Wasn't found until my surgery for mastectomy. That bought me chemo. My MO said my oncotype test would probably come back high so that I should just do the chemo and hormonal drug. I was a grade three and was give two choices for chemo. ACT or TC. He wouldn't tell me which one. I had to pick. I felt like all my decisions were mine.

gracie22

Scared, I don't get it either. Personally, I would prefer to do the surgery first, a sentinel node biopsy and then the oncotype, and have a shot at skipping chemo. One of the major improvements in the last decade or so has been the ability for high ER/PR+, HER2-, low grade cancer patients to opt out of chemo if the oncotype shows that it has little chance of helping. Why sign on for that if it has little value? I would want a better explanation for why they are pushing the neo.

KBeee

Definitely get multiple opinions. It is your right to know WHY they recommend a certain treatment plan

Logang

I was stage 2, no nodes, strongly er+. I had a Unilateral mastectomy. We thought no chemo until my oncotype came back at 57. So chemo and hormonal therapy drastically lower my risk for recurrence.

Nancy2581

I'm stage IIB grade 1. I had one positive node and that bought my ticket to chemo. I also had LVI and my tumor was 2.8cm. Though I wanted no part of chemo at all I'm glad I did it. It wasn't as bad as I thought and it does give me peace of mind (I know anything can happen, but I'm glad I don't have that nagging feeling of thinking I should have done it)

Nancy

ruthbru

I was stage II, grade 3......a large 4 cm tumor but node negative. I had a lumpectomy, chemo, rads & 5 years of Arimidex; and am now almost 10 years out. I am glad I did everything that I did. They didn't offer chemo first back when I was diagnosed; but if they had, I would have chosen that option for the reasons that I could have then known if the chemo was working, and if it worked and the tumor would have shrunk, I could have had less tissue taken during the lumpectomy.

Jackster51

I regret doing Taxotere and not getting my hair back..

ruthbru

I did 4 rounds of AC, dose dense (two weeks apart) with Neulasta shots. I am glad I did it that way because I wanted to get it over with as quickly as possible. Plus with Neulasta shots, I didn't have to worry that much about getting sick. I am a teacher, wanted to keep working, and kids are germy!

jojo9999

A positive node does not necessarily indicate chemo. If it is a very large node, or very high grade, then perhaps. But no longer does a positive node necessitate chemo. I had a positive node and an oncotype score of 4. The low RS score and the low grade reinforced each other. (Scarey to think, but there is such a thing as a false positive node - docs don't like to talk about that but there is research on it). There are a few threads on the boards discussing Oncotype scores for node positive disease. there is a poster named BARREDOWL who is very knowledgeable about this. Most insurances now cover the Oncotype test for patients with 1-3 positive nodes including macromets, because they know that some of these women can skip chemo! Surprised that a doc at MSK isn't on board with the testing - of course there could be other issues that are factoring that were not given. I would press for an explanation for why you don't qualify for the test.

Nancy2581

true jojo, but in my case my tumor was much bigger than your's 2.8cm and the LVI scared the crap out of me. My onc wouldn't do the onco test unless I was put in the trial going on for node positive premenopausal women. My onc was afraid I'd get the arm with no chemo. She really felt I should have it. It's ok - still I would have liked all the info that comes with the onco test and I have no regrets for doing chemo.

Jackster - I hear you about the hair loss. I was originally to do TAC where the T is taxotere. I didn't handle the first round well and my onc immediately switched me to ACT (taxol). I was really worried about taxotere and I'm so very sorry hair loss has happened to you. Hugs

Nancy

7of9

I had node positive before neoadjunct chemo, node negative after and a bilateral mastectomy. They were on the fence about rads after and decided not to. I reoccurred 3 years later. Whatever you do - be damn sure it's your call and not theirs. I pushed for rads and they said no. I should have gotten a second opinion. Part of me just wanted my bottle of Tamoxifin and to just walk out the door. I was tired but scared it would come back and it did. Not doing everything first go around cost me many regrets. Sorry but it's the truth.

scaredashell07

so I got a third opinion and they said I could go either way. But not for same reasons. Said that chemo would possibly shrink the tumors (I have three) and possible clear some of the nodes (or not) but that it gives us a chance yo see how tumor responds. And I will now have the oncotype with my new doctor. I have chosen surgery first because they said er pr+ her2- tumors don't usually respond to chemo very well so what's the point in keeping the tumors in me for 4-6 months ??? Ubless I am thinking about it wrong. Is the cancer killed in bloodstream immediately?

norak

Hello

I was diagnosed with Stage 2A Breast Cancer on June 22nd 2016 .2 Lymph Nodes involved. ER/PR+ HER-. I had a lumpectomy (with clean margins )with a sentinel Lymph node removal. I started Chemo after much research and much debate. I am also doing complimentary treatments. I was on the verge of only doing alternative treatments but decided to combine both. My Mamaprint results came back as High Risk for recurrence. I did all the genetic testing and all came back negative. Chemo is done as a security measure in case you still have microscopic cancer cells in your body. Once Im done with chemo I am supposed to get radiation treatment. I am questioning whether this is necessary. Has anyone decided not to do radiation in addition to Chemo?

Fe_Princess

Hi Norak, I decided on neither and had a mastectomy which in hindsight wasn't such a great idea because the result was four subsequent surgeries in a very short amount of time. I can understand your angst. I have not heard of Rad after Chemo for stage II. When you say your Mamaprint came back high risk but genetic tests negative, which genetic tests did you have? Did you get the Oncodx genetic test? Can you tell me what a Mamaprint is. I was never offered anything...

scaredashell07

I am so scared that if I get the chemo first the tumors are still there and the lymphodes are growing. If I get the chemo after the cancer in my bloodstream or micro amounts in my nodes are still there. am I wrong about the way I am thinking?? I wish I had a professional who would say one way was better than the other.

they found ' a few nodes' positive on MRI scan after biopsy but they wanted me on chemo first even before the biopsy. at the time they saw I was node positive on US. If I wasnr node positive at all would have not been chemo first.

Grannemama

Hi scared,

I have a similar diagnosis, recent too, and we both live NJ. My MO presented the case for neoadjuvant chemo too. No disadvantages, whether the sequence is chemo then surgery, or surgery then chemo. But one advantage to chemo first is shrinking the lymph node tumor, maybe won't have to be removed, then avoid lymph edema. In my case, I'm not trying for breast conservation they're small

scaredashell07

Isnt the disadvantage that the chemo may not be killing the cancer and the cancer can still travel

Grannemama

Wouldn't that be the case after surgery too

scaredashell07

grannemama- yes but if the tumors and infected nodes arentout doesn't that mean that the tumor and nodes could still be holding cancer and possibly travel?

Nancy2581

The one advantage to doing chemo first is that your oncologist will monitor you closely and you will know if the chemo is working or not. It won't take long to find out. Yes, it may not work but as another member mentioned that is true for chemo after surgery too. That's how I had chemo (after surgery) have no clue what it did (if anything) for me.

Nancy

ruthbru

If you have a lumpectomy, rads are part of the equation. Because you have breast tissue left, you need radiation to prevent a local recurrence. Chemo is meant to kill any rogue microscopic cells that may have already escaped the breast area are lurking elsewhere in your body.

scaredashell07

but they didn't do an oncotype test so i have no idea if it will work and if it doesn't im waiting for 6 months for surgery. Couldn't it travel while its still in my body

CCtoo

scsred,. I would do surgery first!! Sounds like you just want cancer out of body so it won't spread....I did too! You can do rest after cancer is out!!