Microscopic cancer in one lymph node

Ellen - I agree it's scary & confusing!  These tiny cells wouldn't even have been found a few years ago.

Here's a definition of a micromet from a previous BCO thread: "A micrometastasis is between 0.2 and 2 mm.  If it was smaller than 0.2 mm, your onc can call you node-negative or NO(i); if it was larger, you would be designated as N1(mi). "

The cell they found in my SN was 1 mm so I'm considered node positive, yours must have been smaller to be considered node negative.  Best wishes as you wait for test results and make your decisions.  {{hugs}}

Thanks for your responses. I just received my oncotype with a score of 12. The oncologist says no chemo. I am not 100% sure this is the right path because of the isolated tumors. But I would not be 100% of chemo if that was the decision. I am just going with what the oncotype says and hope for the best. If bc revisits I will throw everything at it then. I have made lifestyle changes(eat organic, a lot more exercise, reduce stress) to ward off any future cancer and hopefully that will help.

I'm so glad I found this forum. I have been driving myself crazy trying to decide if I made the right decision, which was to go forward with chemo.

In January, I was diagnosed with a 3 cm IDC in the right breast, but the lymph nodes looked good. My surgeon was thinking lumpectomy, possibly chemo, and then radiation. After lots of routine screeening (Pet/CT, Bone Scan, MRI, and Breast MRI), the picture became a little murky and it looked like I might have multiple tumors. Several biopsies later, it was determined that I had at least what was likely a precancer and that it would have to come out along with the IDC. Unfortunatley, that meant a mastectomy because the two spots weren't close together. After surgery, it turned out the 3 cm tumor was really 2 separate tumors (1.9 and 1 cm) and I had another one that was 3mm. There was also 2.5 cm of DCIS--so mastectomy was the right choice.

Initially, the surgeon removed 2 sentinal nodes, which looked OK in the operating room, but the final pathology report said a few cancer cells in one and a moderate number (<200) in the other. Because the tools used to find these cells has improved so much over the years, this is technically 'node negative.' My surgeon suggested the Oncotype DX test and he suggested I join a clinical trial. The trial is attempting to sort the intermediate scores as to whether chemo really helps. If you join the trial and get an intermediate score, getting chemo is randomized.  I have to admit that I sort of freaked out. I couldn't imagine getting a higher score and then not getting chemo. Clearly, I wasn't a good candidate for the trial.

In the end, I decided not to get the Oncotype DX test at all because even though the current thinking is that I'm 'node negative', there were a moderate number of cancer cells in one of my nodes and both nodes had some cancer cells. I told my oncologist that I wanted chemo and he agreed.

 I started last week on CMF for 26 weeks and so far so good. But I keep getting that nagging feeling that I should have done the Oncotype test or that I shouldn't be putting my body through the six months of treatment. I've agonized over the decision and wondered if I'm doing the right thing.

 After reading these posts, I feel better because I see that I'm not the only one agonizing and that there aren't really any easy answers. It comes down to making an individual choice after weighing the benefits and risks. I'm 44 years young, have two daughters (12 and 9) and I've decided to do whatever I can to get rid of my cancer.

This was longer than I intended -- Thanks for letting me vent!

Codavis: Oh, I can relate.  If there's one thing I've learned from BC it's that the journey is a series of very difficult decisions, especially if you're the kind of person who likes to research and analyze data and take an activist role in your care (as opposed to simply accepting whatever the docs say).  Another lesson I'm trying to put into practice is: Once you pass a milestone, try not to look back... as my surgeon once said, "we have to make the best decision with the information we have at the time."   

My 48-year-old mum had breast cancer (progesterone and estrogen positive, HER2 negative), she was diagnosed in 2008. Her tumor was less than 3 centimetre, I don't know its exact size, but as far as I remember it was 2,6 cm or something like that and during the lumpectomy a 2 milimetre tumor was found in her sentinel lymph node. The surgeon took it out with two other lymph nodes (the others were all clear). She is on Zitazonium (Tamoxifen) and Zoldadex injection (in order to stop her ovaries working). Is anybody in the same situation? Does it mean that she will die? I am confused. How serious is it when only one lymph node is positive (the other are neg.)?

Thanks for you post groundhog! Life would be much better without cancer. I like your attitude, keep it up! My mother's attitude is sometimes good, but sometimes it's not. I hope it will change ).

Cisatypo -

My story is quite similar to your's and I agree that everyone has a very personal decision to make regarding all of the treatment options.  I had micromets in one node out of 20.  I asked for and was able to get the onco test and mine came back quite low.  That was my deciding factor - not to do chemo as a result.  Plus my BC was very estro positive and my onco thought the hormone treatment would be the best thing I could do, more effective than the chemo...only time will tell.....I am so good with my decision though...and happily moving on with my life!!!!

 Julie