Microscopic cancer in 1 lymph node...to do chemo or not??

Technically Oncotype is only if you are node negative, so take the info with a grain of salt. So one node tested had some cells, enough to do chemo is really a personal decision. Sis had 3 negative sentinel nodes and doc did ax dissection anyway as the nodes looked abnormal and her tumor was large - over 1/2 were positive. Interestedly this was after 5 months of preop chemo so in her case her tumor wasnt that chemo sensitive, Doc said very ER/PR+ so Tamoxifen or something similar forever.

Trust your team, get a 2nd opinion and trust your gut. Chemo is doable if you decide that route!

Good luck

Hi

I had one positive node and did chemo.

diane

Hey Janina,

Chemo is doable, not easy but doable. I am being seen at Dana Farber I talked to some amazing onc's . You are grade 3, just like me, that means the cancer (even though it was small) was aggressive. Which means it had the motivation and the intention of growing very big and spreading.  If you do have a reoccurance you automatically become stage 4. There is no stage 5. Listening to some of the women with Stage 4, it is an education in cancer, they know what they are talking about it because they are living with it. I think, in my very humble opinion it would be a grave mistake to skip chemo because there is NO going back and undoing a decision you made out of fear. Chemo is a little extra life insurance it might work, it might not but I certainly did not want to regret my decision in the future. I wanted to do the best I could to kick cancers, mutant, oxygen starved, evil, over multplying self. I can tell you I had a small tumor 1.5cm grade 3 and I'm half way done with chemo, again, it's not fun, but it's doable. 12 weeks and it would be over for you, you would be done with chemo.  You would probably get it every 3 weeks, with 3 weeks to recover. It is different for everyone, some people don't get many SE's, others say fatigue has been the worst, but you get through it. I hope I helped. Good luck with YOUR very important decision. CH

I had a couple of nodes positive, so chemo was a given for me.  But if I had only had one I still would have done it without question, as I will do anything to be around to see my toddler grow up.  Chemo wasn't fun, but I got through it.  No matter what happens I will never have to look back and wonder if I did enough.

Good luck with your decision.  I'm sure it's not an easy one. 

Janina, Get your oncotype score, review with your onc, and get another opinion if you feel uneasy. I had very small IDC, 0/10 nodes, Grade 2, bilateral mastectomy and 4TX taxotere & cytoxan. I only got sick 2nd day after 1st TX. Onc just "turned off" the nausea with one tiny pill...took about 10 - 15 minutes. Hair loss was just not a big deal to me. I knew it would grow back, I just wanted to be alive to see it grow again. I got a wig (to please my grandson and my dd). I ended up getting many compliments on my new hairstyle. After my hair started growing enough to go without the wig, I heard many "oh, why did you cut your hair so short? It looked so good!" I just laughed. Now I have had 5 haircuts in the past 12 months.

I think I have a very aggressive onc. I think you have a greater chance of long term survival of bc if you really go after it hard on the 1st occurence. After that, my onc told me it didn't matter that much how soon a recurrence was discovered...the outcome would be the same.

My chemo was not nearly as bad as I had envisioned. Drugs to control side effects now are marvelous! Nothing at all like the drugs 3 of my aunts had to combat bc and chemo SE's

Good luck fellow Texan! And remember how tough Texans are! lol

My onc layed out all the facts including my oncotype score, which was 17 I think...just know it was the highest number in the low risk range, the type of chemo  & # treatments she recommended. Then she told me she could not tell me to do it or not. It had to be my decision, but if it got too rough at any time I could quit. I was think NO, NO, NO! Then before I left her office I told her I would at least try it. Later she told me I made the same decision she would have made if she were in my place.

I had 2 "specks" of the dye they used in one SN and one "speck" in another SN.  I am not real sure but it was something like this dye showed up where the cancer was.  They called it microscopic.  The surgeon that did my lumpectomy told me they didn't call that positive.  

When I went to MD Anderson, the onc there said, "No, we don't call it positive, but we don't call it negative either".  So he recommended chemotherapy. Of course as you can see mine was Lobular BC, slow growing, but mine was 4.5cm and had probably been there for 6 to 8 years.

I did 12 weeks of Taxol once a week and worked the whole time.  My hair came out.  That was a big deal to me.  I didn't want chemo because of the hair loss.  But like the others have said, I wanted to live (and I was 67 in 2006 when I was DX'D.)

I went to Ann's Wig Shop in Houston and got a great wig.  Like someone else said no one ever knew I had a wig on.  I had people ask me where I got my hair cut.  I would just say,"You too can have this hair.  It is for sale in Houston". LOL

Good luck and God bless fellow Texan.  I certainly understand how you feel.  As others have said it is not fun, but doable.  I also had 4 doses of Cytoxan, 5Fu and Adriamycin.  One every 3 weeks after the 12 doses of Taxol.

Being young, you have a lot more life to live and worry about recurrence.  Do what your doctor recommends.  Go for a second opinion. I highly recommend MD Anderson and my wonderful doc is Dr. Daniel Booser. 

hi...I had one slight positive node, and did not do the chemo.

The difference between 1-2 nodes and node negative is slight.

MAKE SURE YOU ASK YOUR ONC FOR THE 4 PAGE REPORT

The last page has the node positive chart.

Good Luck!

hi janina, just want to say you are not alone about hair loss. when my breast surgeon told me about chemo, i cried and said no, no, no..i dun want chemo and like yourself, am concerned about hair loss.

to support me, one of my female colleague to going to shave her head. she said 'being hairless n looking bald is nothing! healing n recovering fast is more significant than anything esle' and this woke me up.

1/3 nodes tested positive and am going for chemo (starting feb). I want them out of my body!!!!!

Doing chemo doesn't guarantee that the cancer won't come back. 

Hormone treatment (Tamoxifen) actually is more effective for those whose tumors are hormone receptor positive, and there is some thought that the main benefit of adjuvant chemo for pre-menopausal women is that it causes menopause at least temporarily.  Doing chemo delays starting the more effective hormone treatment by months, as long as 6 months or more. 

Chemo will cause hair loss which is usually temporary.  It can also cause cardiac damage, nerve damage and other cancers, those side effects are often permanent.  The incidence of those permanent side effect is often about equal to the percentage of benefit from chemo.  Different chemo combinations are more/less likely to cause specific side effects. 

Do the research.  Understand the potential risks posed by the specific combination of chemo agents being proposed for you as well as the potential benefits. 

Questions to ask include" What percentage of patients on this regimen nail's fall off?", "What percentage of your chemo patients are hospitalized with infections such as pneumonia?", "What percentage of patients on this regimen have permanent side effects? What are those side effects?"

If your oncologist tells you that those things dont happen, run to someone who can write a prescription for Tamoxifen and don't look back.  Because if your oncologist isn't willing to be truthful about possible problems before you start chemo, there is no possiblitliy that they will be there when you run into a problem during chemo.

Is CMF a possibility...you lose 20-50 percent of your hair. It would seem like a reasonable choice if you are a borderline case. That was the chemo that was offered to me. Maybe ask your doc what he thinks? There is also a very long CMF thread on this site.