Am I crazy for wanting chemo???

My tumor was 1.5 cm IDC, ER+PR+ HER-. Age mid-fifties. I had a mastectomy.  My surgeon and oncologist initially said no chemo necessary.  Then my oncotype came back 23 (middle of intermediate).  That made chemo up to me. My oncologist said whatever I decided was o.k. with him.    They are now doing trials to see if there is a benefit for those with intermediate scores to have chemo.

My family really wanted me to do chemo. They wanted me to throw everything at the cancer that was available.  I was on the fence until my surgeon asked me if I did not have chemo and had a recurrence, could I handle that with no regrets.  I could not.  I would have always wondered if I had done the chemo would the outcome have changed.

 Bottom line, I did the chemo. 

That was my thought process.  You have to do what is right for you.  You will know what you have to do to give yourself as much peace as is possible in this  situation.  I wish you the best as you continue your journey.

Not crazy at all. When I started this whole crazy ride I went into surgery planning on a lumpectomy and radiation and being done. The thought of not having chemo scared me (well, so DID the thought of having it but...); I was afraid of not doing everything I could to increase my chances. As it turned out I had 1 positive lymph node so my decision was made for me. I still believe I would have pressed my onco for chemo had I not come back node positive. I'm not going to lie to you, chemo sucks with a capital S, I just completed #3 of 8 and I often wonder if I can make it through all 8. What keeps me going is knowing that I'm doing this for my life. There are no guarantees this will keep it away but I know if it does come back that I did everything possible at the time. 

What about CMF....it is a good option when you are in the grey zone, lower risk of major SE's. And 20-50% hair loss.

BTW I did not do chemo with 22 and a node, but it was the hardest decision ever. Make sure you look at the charts that come with the report, and the curves for chemo benefit. Ask the office to print the report out for you.

I think you are right to consider your age and tumor size. Do you know your KI67?

Some low onco people have high KI 67, and they may be the ones who have a higher risk.

Hope I helped.

I think you are a really good candidate for a second opinion as well.

Hi- I second the recommendation for CMF chemo.  I had a score of 23 - so higher than yours (in the gray zone) and was 44 years old at diagnosis.  CMF is very easy to tolerate (usually) and I had virtually no side effects.  Not that hair is the most important aspect of life, but hair loss is not a side effect of the chemo- a bit of hair thinning, but not enough on me to notice.

I agree that your age and tumor size would make me a bit nervous and want more info, or possibly a second opinion.

I have to admit that I have a real problem with the position that one must understand the degree to which it will benefit.

I think even a small "benefit" is worth the potential risks. There are serious risks to some of the diabetes medications I take, as well, including heart disease.

But that's why each of us have to make our own decisions and go with our gut, which usually means, as was mentioned up-thread, can we live with this decision if we do get a recurrence later.

For me, the issue of possible "recurrence" has already been answered before I even started my first infusion.

My oncologist ordered a set of scans (head, chest, abdomen, pelvis and bone). All were clear except for 2 lesions on my liver.

My tumor was only 2.7cm big, clear margins, no node involvement, and he restaged me from Stage II to Stage IV before they even pumped the first drop of chemo into me.

I wish none of us ever had to make this decision. I wish not a single human ever had to make this decision.

But I don't believe in magical thinking. I do believe in action. At least, in my own gut and mind, I know that I have done and am doing everything humanly possible at this point in time regarding our knowledge of cancer treatment.

That's the best any of us can do, I suppose.

Dear Horsedoc, I don't think u are crazy. If having chemo would make u feel better then u should have it. It is a very personal decision. Most women are terrified of breast cancer but my phobia is a heart attack. I have almost the same dx as u but I elected not to do chemo because I am more scared of the side effects( like heart damage)which there is probably not much chance of  than the chance of the cancer spreading.. I have to do radiation and tamoxifen for 5 years. Some women do the chemo and not the hormone therpy. My oncol says that the hormone therpy will do more to prevent the spread of the cancer than chemo. He would rather me do both. You have to read all u can and educate yourself and make a decision u can live with. Maybe if u feel more comfortable haveing chemo u could have a low dose chemo like cmf. There are not as many side effects. Good Luck

One thing that you may want to consider - and I was grade 1 as well, is that chemo just doesn't work very well on grade 1 tumors. Chemo acts by attacking fast-reproducing cells, and we just don't have a lot of fast-reproducing cells. This doesn't mean that women who have node involvement shouldn't take chemo, but my doctor said that the percentage of benefit increase would be less than the danger of chemo, and their first duty is to do no harm.

That said, what about your other factors. Did you have any associated DCIS? Did they get really good margins? If you had a small, indolent tumor that hasn't shown any tendency to spread, then what, exactly, will chemo get you?

I didn't get any of this, and finally went for a second opinion. Two doctors explaining it to me and I finally got it. That, and knowing a woman who died of chemo-caused leukemia, and another who is now dying of heart failure brought on by Adriamycin...

Today, I am comfortable with my decision. Talk to more docs if you need to - how you feel is the most important thing you can do. 

this is a tough one--I was in the gray area and had to decide-- and I went with 4 rounds--- I tolerated it well, but as has been said, everyone is different.  Just want to point out you don't necessarily have to have a port with Adriamycin.... I had it and no port..... 

 Lots of folks here have info about the side effects of the taxanes.... you should be able to get really good info.  

As my onc put it-- " you are in a good situation, the treatment makes it even better"