Stage IIA with no Chemo

Yes you should do chemo, based on your age, and the grade IIa.  You can do it!

While I am older than you, I had a similar pathology report.  I refused chemo based on reading the research reports.  All of them had statements in the "Discussion" sections that the benefit of chemo in early stage bc was unknown or unclear.  I could not justify putting myself through the side effects, or taking the risk of permanent nerve damage for a treatment that is not proven for Stage II bc, nor was the risk worth increasing my percentange of being recurrence free after 5 years from 95% to 97%.  More recent research has raised a question about chemo in early stage bc--if the beast comes back, it is usally resistant to the chemo it has already been exposed to, limiting treatment options.  Women who do not have chemo who have a recurrence seem to have a better response to chemo at the later point in time.  The researchers are wondering if it's similar to bacteria being exposed to antibiotics but not completely killed off--the bacteria then develop resisitance to the antibiotic. 

yunlee - I would also advise chemo, depending on the oncotype score.  My score was 23.  I did CMF chemo, which is considered easier to tolerate.  It also leaves the heavier chemos as options - if you have a recurrence. 

Once you have your oncotype score, you will be able to assess your options better.  

Your age and grade do indicate a recommendation of chemo - as Pure wrote, 90% vs. 98% is a big difference.

yunlee--make another appointment with your oncologist and ask why he/she would be comfortable not giving you chemo if the oncotype score is low since he/she would give you chemo based on the pathology.  Also find out if your insurance will cover the oncotype test, not all of them do and it is an expensive test.  Have the onc give you recurrence and life expectancy percentages with and without chemo based on the pathology report.  That will give you more solid information to work with, and hopefully be less confusing. 

If insurance won't cover the oncotype, Genomic Health will help you appeal (they are the oncotype lab).  I thought most insurance in the US  cover it  - as it is now standard of care, but I could be wrong. Mine covered it.  They did not cover the BRAC testing, or zometa for stage 1, so don't cover everything my onc. would like.  I did the BRAC testing anyway - which is not a bad idea for you to do as you are young. 

I think talking to your onc. again sounds like a good idea.  A second opinion is never a bad idea either.  

HI NATIVE MAINE...Want to make a comment . Women with  a two inch Solid- tumor.

HER2+.   How would you shrink a 2cm tumor without the use of Chemotherapy before the

actual lumpect or the masect surgery. What are the options for us women, if any?

Please tell me.

hi in my friends situation, let me explain, she was diagnosed with DCIS, HER2. In your opinion, is this an aggressive form of breast cancer? Her oncologist/surgeon wants to shrink her 2 inch

 breast tumor first  before admitting the lumpectomey surgery she prefers  Where  she is receiving

 the oncologists/ breast surgeons don't remove breast cancer tumors quickly, right away if that's

the hospital's system and or up to the patient's saying's  perhaps she should of asked if she  could of had the procedure. She is in chemotherapy now,after she is done with the  treatments,

 perhaps she should ask, What's the next step and also if   she could have surgically remove at any time she feels wishes to.

What is your opinon Native Mine?

Hi-I had a similiar diagnosis-stage 2A, no node involvement. I was 41 at age of diagnosis, though. My oncotype came back in the grey area and I chose not to do chemo. My oncologist wanted me to at first because of my age-however he agreed with my decision because chemo could've only lowered my chance for recurrance by 2% and may have actually not helped at all. It was a long and hard decision and a very personal one. My grade was 2, though but my tumor was 3cm. I did surgery, 33 radiation treatments and am now on Tamoxifen. Whatever YOU decide, good luck to you.

Hi Yunlee72,

This is a very personal decision and one that only you can make.

A few things I thought about when I was going through it were that many (too many) women have done this already--I wasn't the first & unfortunately, I'm not going to be the last and if I opted out of chemo and 10 years down the line it came back, I would never forgive myself. As we all know, It may come back but at least I know I did everything in my power to stop it.

It's not easy but is it doable? Yes. It's so scary, I know, but there are countless women before you who got through chemo--as tough as it was.

You have to make a decision and be settled in that decision. You're in the right place for support. I wish you well.   

Yunlee72

we have a very similar situation.  I was diagnosed in January, my tumor was over 3 cm and I am also 37.  I did have the oncotype score which came back as 16.  My oncologist said she would support me in either decision, to have chemo or no, but she also consulted two other oncologists about it and they all agreed that given my age and the size of the tumor, chemo is a rational thing to do.  On the other hand, if I was comfortable just doing Tamoxifen, she would have supported that too.  

My Ki67 score was also high, which is suggestive of quickly growing/more aggresive tumor and that also played into my decision, as did some family input, but overall it was a personal decision to have chemo. I just finished my second round of Taxotere/Cytoxan yesterday; I'm having a total of 4.  

Good luck in your journey, and don't be afraid to see another oncologist for more input if you are still questioning your decision.