Is chemo always recommended after mastectomy(ILC)?

Janebiggie

I had mastectomy 2 weeks ago, ER+, Her-, oncotype score 21, lymph nodes were taken out and 2/21 infected. Met with oncologist a few days ago, he seems to suggest chemo and radiation, though he won't say for sure until PET scan result.

Got the PET scan report but won't see oncologist again until another day.

Is it true that for ILC, young-ish age (40), they always recommend chemo? And radiation?

How to approach a doctor for second opinion? How many doctors do you see before deciding the treatment?

Moderators

Hi Jane, and welcome to Breastcancer.org!

We're so sorry you have to be here, but we're really glad you found us. You're sure to find our Community an incredible source of information, advice, and support. We're sure others will be by shortly to weigh in with their thoughts. In the meantime, you may want to check out the main Breastcancer.org site's page on Systemic Treatment for ILC, which explains why/when chemo is recommended for this type of cancer. Also, there's a great section on Getting a Second Opinion, which offers advice on how to ask for a second opinion and where to get one.

We hope this helps and look forward to hearing more from you soon!

--The Mods

EastcoastTS

Jane:

I have ILC and am sorta young-ish (diagnosis at 49) and was NOT recommended to have chemo. Or radiation. No radiation because they got clear margins with mastectomy. No chemo because I had no lymph node involvement and Oncotype of 14. (I could have pushed for chemo...but after talking to more than one doctor, all seemed to agree that it would not do much for me.)

Not sure of your tumor size but from quick review of what you've written, seems to me that perhaps it's the lymph node involvement and the Oncotype score that the MO may be targeting by suggesting Chemo. I have heard of some MOs who recommend based on younger age, too, but that seems subjective like much of our treatment! Ask questions about why and what your stats are with and without it. It's your choice to make. Although there is a window of time they like to get chemo started. (Six weeks post surgery?)

Good luck as you make a treatment plan!

Janebiggie

moderator, thanks for the welcome and the links. These are useful. To complicate things, I live (as expat with husband and two kids 6&8yr) in an asian country. So I have to consider where to get treatment. Options are :

a) second tier city where we live, so I van be with my family the whole time

b) the capital one hour flight away with better hospital facility

C) my home country 3 hrs flight away with top tier hospital and doctors.

So far my surgery was done in (b) the capital but I will see an oncologist in my home country this week for second opinion.

beach2beach

Hi Jane.

I would think since you had nodes affected is a big part of the reason they are suggesting chemo. I have/had ILC also at 51 but no nodes and a low Oncotype score.

Tough being in a foreign country. Do you feel comfortable with the Dr or Dr's there? I think its great that you can get a second opinion back at home. I hope it that consult gives you a plan to move forward.