idc and chemo..is it necessary

Hi Terri,

Your stats sound a lot like mine and we are close in age. I also needed a rexcision, but ended up with good clear margins.

My surgeon told me it was the oncologist who determines whether chemo is warranted, though both she and my rad onc weighed in  on the issue when I asked them.

The oncotype test is being used increasingly to help women and their onco's come to a decision. You can google ONCOTYPE dx to get their web site.  There are also several  previous threads on BCO you could read. (Roll call Oncotype dx new)

In my case, with a score of 13 my onco advised no chemo.  I got a second opinion at another hospital who said the same.  Still, it was not an easy decision and I agonized over it.  I felt a lot better after I found this  (BCO) and  read up on it here. Very interesting to see how women come to the decisions they do.

By the way, more and more, insurance companies are on board with paying for the Oncotype test.

I recommend asking for the test and/or getting  an opinion from your oncologist. 

Best of luck! 

Edited to add:  Do you know your grade?  That might factor into whether you need chemo as well. 

As the others have said, it is impossible to know whether chemo is wise or not based on the information you gave us.

There are various factors other than tumor size and lymph node status that factor into the decision. One is grade - do the cells look close to normal cells and therefore not aggressive (grade 1) or do they look very different indicating an aggressive cancer (grade 3).

And more important than grade are some other less subjective measures of how aggressive the tumor is. Cancer cells may have several kinds of receptors that trigger growth. Those that are positive for hormone receptors (estrogen and progesterone) tend to be less aggressive and hormone treatments that block the receptors may be enough.

Those that have HER2 receptors tend to be very aggressive (even if they are also hormone positive). If the tumor is HER2+ recurrence without chemo is relatively high and there are some very effective chemo regimes that reduce it a lot so chemo is a good choice.

If the tumor is HER2- and hormone positive, there is a test called oncotype that looks at some of the genes in the tumor to determine how likely it is to recur without chemo.

Triple negative tumors (those negative for HER2, estrogen and progesterone receptors) are in between HER2+ and hormone-positive HER2-negative tumors and chemo might be good.