Significance Of Studies???

I like reading studies, you don't need to look closely at the numbers, I don't, they are only valid for the particular group being studied, that's why it's important to look at the full study and not just go by the abstract. [Thanks for posting the url btw, did I mention that I like reading studies?]

There is nothing in this study to suggest that what your onc and BC said is not true about your own prognosis with stage 1 cancer and small tumour size with the treatments you have been receiving. 

In this case the women in the study were treated between 1992 and 2005 and followed to 2006. The treatment the younger women age 35 and under with stage 1 cancer received during these years was apples and oranges to what you are receiving, only 22% of the women with a tumour size 1–10 mm had chemotherapy for example. [see quote from study copied at end of message]. Guidelines didn't suggest that younger women, because of their age, would benefit from chemo until 1998 even though their older post menopause, ER+ node negative with stage 1 cancer and small tumours can and could do without chemo  and still have a very very good prognosis, yes even better than your prognosis. 

I was age 65 at diagnosis and last December spent two weeks reading the studies to decide whether or not I wanted or needed chemotherapy after it was suggested. Despite my initial thought that after surgery I had a good prognosis with a stage 2 cancer and with only one positive node and being post menopause and strongly ER+  and that there was little advantage to doing chemo in addition to  the five years of hormone therapy suggested, I at the end swung around and decided to do it.

One of the reasons was that I read the sister study to this Swedish study that compared the prognosis of older women over age 70 women with early stage cancers to their younger middle aged sisters age 50 to 69. Guess what -- these older women didn't do as well as the middle agers either - one reason being that during the study time period these women were less likely to be offered chemotherapy (and still are today). Not that these older women with early stage cancers still didn't have a good prognosis btw, they did, just not as good as the middle agers.

 I know that in my case I will get very little additional benefit with chemotherapy over doing 5 years of hormone therapy alone, (most studies show younger women get more of a  benefit from chemo because older women with slower growing cancers have cancer cells that divide at a slower rate and so are less likely to be killed off by the cancer drugs, but the numbers in the studies still show, even these earlier studies before the introduction of the newer 3rd generation chemo drugs, that the addition of chemo still does help some.

[quote from Swedish research study article yasminv1 mentioned above] "The young women should - according to the 1998 St Gallen guidelines [24]  - have received chemotherapy, but only 22% of the women <35 years with stage I disease with tumour size 1–10 mm and 39% with tumour size 11–20 mm did so. The start of our study period several years before the publication of the guidelines might explain the low frequency of chemotherapy. Consequently, there is room for further intensification of the treatment given to all women</em>"

The other issue is the study said that tamoxifen was not given as often to younger women. Well we know that tamoxifen cuts recurrence in half so this would contribute to the higher return rate (coupled with estrogen fueling the tumors and menopause decades away in some cases). Also younger women, with er pos tumors are back to feeding their tumors more estrogen for longer periods of time once they are off of tamoxifen and so recurrence would be higher than older women going into peri menopause or menopause as the study progressed. People with Er pos tumors can have recurrences 20+ years out and while taking tamoxifen for 10 or 20 years has not been shown to have a benefit, those studies have not, to my knowledge, separated out young women from older women in figuring out these statistics. It may be that younger women who are er positive might benefit from longer periods of tamoxifen or from going back on it after a 5 year break (5 years after being off it so 10 years post diagnosis- rates of BC returning start to very slowly increase after being off it for 5 years).

You can, if you are stage one or stage two and now with both pos and neg nodes and are er positive, have an oncotype  dx which gives you an estimated risk or recurrence after tamoxifen alone or chemo plus tamoxifen.  This study can be done on biopsy tumor or tumor removed at surgery. It is expensive but it might ease your mind a bit.