Recurrence Treatment Without Chemo

Toni_S

My lobular cancer recurrence is confined to one lymph node in the axilla. Time to recurrence was nearly 7 years. I had an axillary dissection and will be having 5 weeks of radiation for sure, but I was given the option of either chemo and hormone therapy, or hormone therapy alone as systemic treatment. The rationale was that chemo has been shown to have little or no benefit for ER positive recurrent breast cancer, and that aromatase inhibitors better target those cells. I opted for the chemo and hormone blockers both, trying to throw as much as I can at this cancer, and after the first round of chemo I am reconsidering whether I made the right choice.

I have been researching the medical journals and looking at recent studies, all of which conclude that the benefit of chemo in treating richly ER positive breast cancers like mine ( I am 100% ER+)is not well-established, and one 2018 study that looked at axillary recurrences like mine recommended that chemo not be used.

Has anyone with a recurrence been offered the option of no chemo? Curious if my team of docs are outliers. I plan to re-evaluate and discuss with my team before round 2. The chemo side effects have been quite severe.

KBeee

Ask them to do the Oncotype test. Mine used it for my recurrence and it helped guide our choice to be very aggressive, even though a major medical center to the north was sure it would not be necessary. It can be done even after some chemo. The first time around, mine was done after 4 treatments (long story).

JoE777

Metastatic-no chemo- femara, kisqali, zometo infusions for bone

Toni_S

I have been told that oncotype cannot be done on a tumor in the lymph node. My decision would be so much easier if I had that data.

Ailurophile

Toni I am 95% ER+ my treatment is abemaciclib (verzenio) plus fermara. I had an oopherectomy to be in surgical menopause so that I can be qualified for this treatment. I was not comfortable with no chemo but my second opinion who was a doctor in one of the National cancer institutes also confirmed that treatment too.

Good luck and wish you the best

Racy

get a second opinion from a major cancer hospital.

trinigirl50

Your recurrence is Pr- which might suggest luminal b, which may be why chemo was an option. However, if the chemo is causing real side effects then it might not be worth it. Did you use hormone blockers after your first occurrence? I read that Letrozole works better for pr- cancer than tamoxifen.

Toni_S

i used Arimidex for 5 years after my first diagnosis. The recurrence was found 2 years later. Wondering if I should have taken it longer.

My oncologist has suggested using a reduced dosage going forward to lessen the side effects. I may do that