chemo or just tamoxifen? Help

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MAMAQ
MAMAQ Member Posts: 240
edited June 2014 in IDC (Invasive Ductal Carcinoma)

Can someone please help?  I was originally diagnosed, after biopsy, with DCIS w/ microinvasion.  Tested positive for BRCA2, so chose to have bilateral mastectomy & oopherectomy & SNB (4/28) I ended up having a micrometastisis in 1 of 2 Sentinel nodes.  3 more intramammory nodes were clear.  The node micrometastisis was 1.9mm.  So very close to the 2.0mm that they consider positive.  I'm also, er+, pr-, and her2/neu -.  My problem is this: 1st onco. said tamoxifen would be enough.  Sought 2nd onco. opinion who said he would consider that positive and wants to do TACx6 chemo.  I am not opposed to doing chemo (if needed) I dont want to wonder what if, though.  Has anyone else been in this situation or have any info on this situation?  I would love the help, I think I'm going to lose my mind soon.

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  • soprano
    soprano Member Posts: 44
    edited May 2009

    Have you had an oncotype test done?  That score might be helpful in making your decision.  Unfortuanately some insurance plans don't cover it and it is expensive. The oncotype test sounds like it might be the perfect tool for you though. There are oncotype threads on this site that you may want to peruse. Sending good thoughts.

    Soprano 

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited May 2009

    MAMAQ - I agree that the oncotype dx may be a good test to give you a bit more info.  I know it can be done on node positive cases that have just a few positive nodes, so micromets should be fine.

    I have a dumb question - I thought DCIS could not travel, so how did it get into your nodes - even micromets?????  Was there IDC in there too???  My tumor had both IDC and DCIS - although more of the IDC.  

    Either way, the oncotype could be a big help to you - there is another woman on the boards - I think named Britt that had micromets and her oncotype score was very low so she did not have chemo.

    April

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  • MAMAQ
    MAMAQ Member Posts: 240
    edited May 2009

    Soprano and aprilgirl1-

     Thanks for the responses.  I'm sorry that I forgot to say that they tried to do an Oncotype dx and I didn't have enough cancer to test.  I should be happy about that but it definately is making my decision harder.  My path shows mostly DCIS but a microinvasion of IDC.  Which I think is why my doctors are differing on the course to take.  That and the fact one considers me node neg and one says node pos.

    JO

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  • dlb823
    dlb823 Member Posts: 9,430
    edited May 2009

    JO ~ Depending on where the oncs are that you've already seen, you might consider going or sending your records to one of the NCI-designated cancer centers, such as MSK, JH, UCLA, etc. (depending on where you're located) for a third opinion.  My rationale is that those larger places see far more bc than local or regional facilities, so will surely have more experience with non-routine situations like yours.  Also, the fact that you're positive for BRCA2 probably figures into the question, and that's also something that will be more commonly seen and understood at a true, university cancer center.

    The other thing I wanted to mention is that many oncs are going with TC now over AC or TAC.  For many women, TC x 4 is just as effective, with fewer potential long-term SEs.  There's plenty of information about it and the research that favors it on various threads here.

    Good luck with your decision.  I think finding the best onc is your key to resolving the question...    Deanna

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  • soprano
    soprano Member Posts: 44
    edited May 2009

    I completely agree with Deanna.  Also the grade of your cancer and your age may be a factor in your choice.  Many oncs don't seem to want to make the choice for those in the gray area, and it is such a hard decision.  My mother also had a difficult choice about treatments as she fell in a gray area (no positive nodes but a higher than expected oncotype score.  Although not one that was high enough to definitely qualify her. Ugh.) I went to all of her appointments with her and see how difficult that decision must be.  In the end she went with TC x4.   You have to try to do what's right for you based on the opinions of the doctors that you trust most.  Again, my thoughts are with you!

    Soprano

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