Mother Diagnosed T1a

Your poor mother has been put through the ringer. My condolences on the death of your father. Your plate is quite full.



I was also diagnosed as T1a. I had dcis and Idc in one breast, with the idc 95% contained. I still opted for a mastectomy. I got clear margins, no node involvement. Because the tumors were so tiny, (less than 1mm total), I did not qualify for chemo. Rads, in my case, were not necessary. I am ER/Pr+, Her2+. I did ask my forner onc. as well as my present one, and both of them said that the side effects of chemo outweighed the benefits of chemo. There wasn't going to be that much difference, so neither one of them offered it. I am on Femara, and have been for the past 4 years. So far so good (I find out for certain tomorrow with visit to onc. to go over labs.)



I really don't know what I would do if it were my mother. I'm like you...the first reaction is to go after it with full guns. Maybe a second opinion here is warranted. What does your mother want? As to types of chemo, I don't know. But, one thing I woudl consider is quality of life. You might post over on the "older ladies" thread. There could be someone who will give you some insight there as to their experience. Someone should be along shortly.



Here's hoping you quickly find the answers you seek.



Jennifer

So sorry about your mother. But it sounds like her diagnosis is very positive as far as breast cancer is concerned. I too had a small her2+ tumor. Mine was 5 mm. Doctors were on the fence with regard to chemo, but since I was only 40 and had 3 small kids I went ahead. I can tell you that after having been through it, I would not recommend your mother have chemo for such a small tumor. Especially if the benefit is only a few percentage points on survival. Good luck with your decision. Noelle.

Random--I don't think there is a normal course of treatment for older women. The latest NCCN guidelines recommend consideration of individual circumstances for patients 60 and older.I was 66 when diagnosed, and since chemo offered me a 0% benefit, I wasn't in the mood to try it. A 1% benefit doesn't seem much better.  The odds are strongly aginst your mom being that lucky, hypothetical 1 in 100 who survives. A more likely result would be that 5 or 6 women would benefit to some extent from chemo, but would not have a complete response.

Your mother's tumor type does appear more likely to benefit from chemo than mine, but at best she might get only a partial response. You need to find out what kind of chemo is proposed. Some have harsher side effects than others, but chemo should never be undertaken lightly, because it can be temporarily and, in rare cases, permanently debilitating. You say your mom's health is good, but how strong are her heart and blood profile? The white blood count takes a  beating from chemo + radiation.

Does your mom have a support network to help her out when you're not around?  You are right in thinking that chemo might be difficult for her to manage alone.