Diagnosed 12/28/17 - Lumpectomy and lymph node removal 1/12/18

ILoveFlowers-Shelley

Hi everyone......just starting on this journey. I have ER+ and PR+ breast cancer. I am 58 years old so also in the post-menopause group. I am looking to connect with ladies with a similar breast cancer situation. My next step will be to meet with the oncologist Feb. 20th. I feel like it is a silly question but do all breast cancers of this type "have to" have both chemotherapy and radiation. Also looking to hear what chemotherapy drugs that ladies have been treated with.

Peregrinelady

No question is silly here. No, you may not need chemo or radiation depending on your pathology. The first thing you need to do is ask for the Oncotype test. It will help you decide if chemo is beneficial for your tumor. Mine was low so I did not need chemo and since I had a mastectomy and good margins, I did not have radiation, either. I remember how shocked I was when the surgeon told me that I might not even need chemo. I didn’t believe him until I researched the Oncotype test. If you do have chemo, there are many threads here for support and answers to your questions.

ILoveFlowers-Shelley

Thank you for your reply. I asked my surgical oncologist just a couple of days ago if they did the Oncotype test. He said they did not need to do it and I kind of got the feeling that it was because my cancer was hormone receptor positive (??) I know I will probably find out more when I meet the oncologist on Feb. 20th but I want to educate myself as much as possible before my appointment. He told me when he proposed the lumpectomy and lymph node removal that I would have to have chemo and radiation.

ILoveFlowers-Shelley

I clarified my question about the Oncotype test. I was told that they did not need do it since mine had spread to the lymph nodes and the results would not influence what they would recommend for chemotherapy. If there was no spread to the lymph nodes then they would do it because the Oncotype can help them decided whether or not chemotherapy would be indicated.He said for node positive women they haven't found that it is useful for any part of their decision making.

moth

Hi, yup, your MOs treatment plan sounds reasonable to me. If you want to connect more with people with similar situations, it might help if you put your diagnosis into your signature line. The stage & tumor grade affect treatment choices as much as hormone receptor status....

The way I think of this is that the surgery is to physically remove the cancer to the extent possible. But some of us need additional treatment like chemo & rads to try to kill off any stray cancer cells that might be circulating. The goal is to prevent recurrence - esp recurrence in areas outside of the breast. So the whole treatment plan is about trying to figure out what the odds of recurrence are and how to decrease that...

There is a website called Predict (by the NHS from the UK) where you can see how much more protection you get from chemo. There used to be another calculator that doctors use called Adjuvantonline but that one is not currently available - I think they're re-calibrating it. Anyway, these tools are part of how doctors develop their treatment plans for us. http://www.predict.nhs.uk/predict_v2.0.html

letsgogolf

The Oncotype test is for those with node involvement. I had 1 micromet. My Oncotype test showed that chemo would actually lower my survival stats. My score was 3 with a 4% chance of recurrence at 10 years. I believe it was 7% with chemo. I had a grade 1 tumor with a very low KI67. Chemo works on rapidly dividing cells which mine were apparently not. If I were you I would insist on the test.

moth

Oncotype can be used for cases where there has been 1-3 lymph nodes involved. But it is also primarily for stage 1 & 2 and only some stage 3s. You can see the guidelines on this page. It's possible that OP falls into a category that would get chemo regardless of onco score.
http://www.oncotypeiq.com/en-CA/breast-cancer/healthcare-professionals/oncotype-dx-breast-recurrence-score/is-your-patient-eligible