If you were stage I, did you get chemo???

Science girl, there is a recent study that shows for patients with positive characteristics X4 is as good as if not better than X6.

I'm not sure if applies to you or all chemos, but I thought I would put it out there, Good luck whatever you chose.

Sorry I can't make the link clickable.

Vitals
Major Finding: With a median follow-up of 4.6 years, the relapse-free survival rate was 91.6% in patients who received six cycles of chemotherapy and 91.8% in those who got four cycles.

Data Source: The CALGB 40101 trial of 3,173 women with good-risk early breast cancer. 

http://www.internalmedicinenews.com/news/oncology-hematology/single-article/in-good-risk-breast-cancer-longer-chemotherapy-isn-t-better/5d7486d2d5.html

Cookiegal,

Thanks for the info, it's interesting.  This study started in 2002-2003, it's comparing AC to T alone, I think?  I wonder if it would apply to TC, somehow I think it would.  With other chemos they have shown that going longer / higher doses doesn't improve outcome.  Also the endpoint was about 5 years, wonder if at 15years a difference would arise.  Problem is I'm NOT patient and I want ALL the answers NOW.

 I was thinking about TC x 6 because that is what they are using in the TIC-TAC trial.  Now I might have to rethink going for 6.

Thanks for you post, it's helpful to me : ) 

I see you're in NY, I'm in NJ are you getting a snow day like I am today?

I am 60, had a 1.8 cm IDC, grade 3, barely ER+, no nodes or vascular involvement, with a high oncotype score (50). I decided against chemo because I am also diabetic and my research indicated that diabetics do not tolerate chemo as well as non-diabetics.  I spoke with three oncologists who all wanted me to do chemo.  I asked about the diabetes factor and they all said "diabetics do fine with chemo."   However, published studies in their own research publications (Journal of Clinical Oncology) indicate the opposite.  One oncologist actually suggested that MD Anderson's study of the impact of diabetes on breast cancer outcomes was "irresponsible."  Seriously???  These doctors were either dishonest or uninformed within their own specialty.  I didn't need to be a statistician to understand the situation and make a decision that was right for me.  I just needed to be able to read and comprehend.

I opted for a lumpectomy, Mammosite radiation and Femara. 

I have a friend who has had breast cancer three times.  The first time she had lumpectomy and radiation.  Two years later she had a recurrence and had a mastectomy and AC.  That was twelve years ago.  She was trying to get me to "throw the book at breast cancer so it wouldn't come back."  Then, within weeks of my diagnosis, she was diagnosed with a new cancer in her other breast and had a second mastectomy.   This time she opted for no chemo, no anti-hormones, no follow-up at all.

There is no way to know if chemo will keep you safe from cancer in the future.  If an oncologist uses the word "cure" or "insurance" you should be suspicious.   Do your own research and make your own decision.  Most importantly, understand the potential side effects and decide if you can live with them, should you be the "one" who ends up with heart damage, permanent neuropathy, permanent hair loss, chemo brain, leukemia or whatever else could happen while you try to kill off the cells that "may or may not" be lurking in your body.   Looking at this side of a chemo decision is just as important as considering how you would feel if you passed on chemo and you had a recurrence.

Michelle

LuvRVing

Good for you, for making your own decision and owing it!  This is our lives and we have the the final say.

Regarding diabetes, google "metformin and breast cancer", some interesting stuff.  There are several clinical trials looking at the benefit of the diabetes drug metformin in breast cancer.  I'm sorry to hear about your friend, my Mom also had 3 seperate bouts with breast cancer.  I often wonder if she did a BMX with the first one if she would have had a better outcome, but then I remind myself that she did what was best for her at the time.  That's all any of us can do.

All the best to you

Oh good, I'm glad your on Metformin!  So does your onc contribute the tumor decrease in size to the increased dose of Metformin?  It must be right? How cool is that.

My hubby takes it, so I pilfered some of his pills and took it for a month.  My oncologist wasn't really aware of it, so I spent today gathering articles that I will give her tomorrow.  After my chemo is over I'm going to look into getting in one of the clinical trials (taking the chance that I would be in the placebo arm).  Wouldn't that be great if a well studied, low side effect, inexpensive, oral drug would have efficacy in breast cancer.

PS-DH gets his metformin for free at QuikChek (a store like 7-11) don't know how they can do that?

My onc was not aware of the metformin trials - I provided him the details last Friday.  I am not really sure there is any way to prove what shrunk my tumor, but I'm giving credit to the metformin.  I asked my breast surgeon and she didn't know.  Nothing in the pathology report gave a clue.

Michelle

Stage 1, Grade 2, Tumor size 1.5 cm, no lymph node involvement, Oncotype score of 11.

No chemo for me.

Mary 

Stage 1-2, ER+ PR+ HER-

no lymphnode involvement. Oncotype score of 20. Yes to chemo.

 Wanted to throw everything at this beast. Chemo was hard but doable.

I was dx'd HER2+++, ER+, PR+ in very late 2001 at age 51, no such thing as Oncotype Dx then, and trastuzumab still in trials so not available either. I did CAF x 6 (refused blood boosters) and wish I hadn't done chemo, as I feel it did negatively affect my life, and that there are far better hormonal treatments including ovarian ablation that would have been better for my particular dx.

AlaskaAngel

Stage 1 (although three cancers, combined measuring 2.5 cm), no node involvement, highly ER/PR +. I had mastectomy (bilateral) and had T/C x 4.

I had SNB and as per my onc there is always 5% of chance cancer escaped, thus chemo. And my age, I was 42 and he said that was still young. He said If I was 20 years older he would be comfortable putting me only on hormonals but not at 42.

Re: young children. My son was 6 at the time. I had mastectomy and was in hospital for 7 days. We told him I would go to hospital and he knew I had boo-boo that had to be taken out. At first we thought I would stay 5 days and he was fine for 5 days. Then, I had to stay 2 more days and he was very upset. We decided not to tell him about chemo. I bought wig that looked like my hair and he never saw me without it. I was scheduling my chemo on Thursdays (You are usually fine first 2-3 days after chemo due to steroids) and then he was in school/daycare Mon-Frid during my SE. In the evening and night I was able even on days with worst SE to put happy face for 2-3 hours before his bed-time.

Now, I am 15 weeks post chemo and telling him I would like to cut my hair short to be like him. At first he did not like idea as girls have to have long hair but now he likes it. It is winter and I would go with wig for another month.

I think we made good decision of not telling our son. I think he would be more scared especially after his reaction to my hospital stay. 

Sorry you didn't get a lower score - but you are still considered in the low range.  My score was 14, which was a 9% recurrance rate with Tamoxifen.  I chose to do 4 rounds of TC.  I'm 37 and had a newborn and a 2 year old at the time.  I got two opinions from NCI locations and both recommended chemo.  I did not have any major issues with side-effects from chemo.  No regrets.  Good luck!

MDG- that;s how things go with this damn disease. We pray for a low score, we get it and we;re pissed it isn't a 1! Mine was low too (a 6) and I went with no chemo. Had I needed it, I know in my heart I would have taken it. I mean for heaven's sake, I was radical in choosing a BMX when a lumpectomy was recommended, there is a point you have to trust on some things. My choice was the BMX to avoid both worry of recurrence in other breast and to avoid rads/chemo. But the point is, I had a choice. If numbers and tumor, etc had been different, my choices might have been different. As it was, I had the BMX with immediate reconstruction and have no regrets. Your doctors sound thorough and most will err on the side of you taking chemo if they thought it best. I questioned mine a million times. It is the nature of the beast. Good luck (I was raised outside of the Motor City a Loooooooooooooooooooooooog time ago-you have some great docs up there-where areyou having your surgery? I used to work at Beaumont when I was in school...in the ER letting patients in with no insurance until they caught me!)

Stage I, Grade I, no nodes, ER+/PR+ HER2-.  Oncotype 21.  Diagnosed June 2010 at 60.

13% chance of distant recurrence within ten years on hormone therapy alone.  That's 13 women out of a 100 who will have another cancer within ten years. Or put the other way round: that's 87 women who will be in the clear at ten years.  Those are good odds.

9% chance of distant recurrence within ten years with chemo and hormone therapy.  That's 9 women out of 100 within ten years.  That's only four women of the 100 who get an additional benefit from the chemo.

Onco No. 1: "You must have chemo -- I'm trying to save your life." 

Onco No. 2: "Chemo is up to you.  We don't know whether it will help or not.  We also don't know where the line is between low risk and middle risk.  I won't press the chemo but I will press the hormones as we know you will benefit from those.  Without them, your risk goes into the unacceptable range."

Onco No. 3: "Chemo is up to you but think about trying it in case it's of some benefit.  If you can't stand it, you can quit.   Hormones are essential. I understand your concerns about the side effects of those but we have choices and we can switch.  Also, you get a benefit from the hormones even if you have to stop because they last awhile in the body.  Without hormones, your risk is unacceptably high."

Decided yesterday to skip the chemo.   With my health problems, which will be substantially increased by chemo immune suppressive therapy and, therefore, likely to come back with a vengenece, chemo is a risk I am not willing to take.  I do not wish to spend time making myself unhealthy and then trying to get healthy again.  I'd rather spend the same amount of time keeping myself healthy.

 Sorry I can't help with advice.  It's all a crap shoot and anyone's advice is pretty much as valuable as anyone else's advice.  When the professionals are all over the block, it's very hard to know what to do.  Science is where it is and that's all we have.

Hello, Otter --

 I know nothing about statistics.  But as I understand the numbers, if I am already one of 87 who will not have a recurrence, then taking the chemo is a complete waste of time at a very high risk of wrecking quality of life now.  And my chances of being one of the 87 are far better than my chances of being one of the 13. 

 And if I am one of the 13, I already know about that risk.  I don't see that taking chemo to MAYBE get that down by only 4 is worth the risk of what the chemo may do to me in terms of wrecking the quality of life I have now and very possibly wrecking it permanently.

It could also be that I get off this mortal coil before the decade is out from something altogether different without wrecking my quality of life now. 

I understand your situation and if I were in your shoes -- five years younger and Grade II -- I'd grit my teeth and take the chemo.  I'd be kicking and screaming and shaking my fist at the sky and all else wraught up and cranky but I would see the wisdom of doing it.  .

I like Onco No. 2 and Onco No. 3.  They are both very calm, no nonsense and in no hurry to get the patient out the door.  I can see why they worked well together when they were fellows at FC.  I'm thinking that a mix of their advice -- get other risks assessed just in case and do the therapy we do know will be beneficial -- is probably very reasonable.  And on top of that, rigid surveillance for the rest of my life.  Which isn't new: it's not that I wasn't at risk for getting BC.  I was and I knew it and I was under constant surveillance..  I just wasn't thought to be at risk for it at this age.

No riding yet.  Plastic surgeon's rule.  But I do get to go to the stable and brush my horse.  It's part of my PT: curry and brush, brush and curry.  I can't haul water buckets or the muck bucket or wield the barrow yet either.  Working up to that.  Have gotten all but about 2% of normal range of motion back so far (physical terrorist says it will come) and now just starting strength recovery and regaining lost muscle.  PT is HARD work.

My onc put it this way: You are 42, have 6-year old son. You have 25% chance of getting it back within 10 years without any Tx, 16% with hormonal therapy alone and 9% with chemo and hormonal. At 52 You would still be young and your son would still be kid. He said if I was at least 20 years older he would give me choice of doing only hormonal. Age is very important.