Node Positive and NO chemo...any of you ladies have input?

That is a little weird. What was your ER/PR/Her status? And did you have micrometastases in the nodes or what? The grade 1 says it's not aggressive, but the three lymph nodes say otherwise. I had grade 2 and only one positive node (strong ER/PR positive and HER-) and my doctors decided on chemo and no radiation. I DID question the chemo part myself as by what I reserached, on strong ER/PR positive (mien was 98% and 96% respectively) chemo does nto do much good, the anti-hormone therapy does.

I think it is because of your grade 1. Chemo attacks fast dividing cells, while a grade 1 tumor is very slow growing, so chemo wouldn't affect it much. It would be of value only if you had any of it "escaped" somewhere and of a different grade than the primary. Did they ever do a PET scan on you?

Grade 2 . Onco 20.  I think 1 more % point up.  Same thoughts.

None of us are saying this decision is for everyone.

But based on other health issues,I was deeply concerned chemo could make other problems worse.

My decison was made during San Antonio, and when the new studies came out making the benefit even less, that did it.

6 or 7 percent I might have gone for it. But with a 2-4% bene and at a 14% RS...that meant there was as little as a 1 in 7 chance it would do any good.

Hi Sereena,

 I had the same results with my oncologist. My tumor was small and a grade 2. I was told no chemo just tamox for 5 years. I am more then comfortable with their decision. 

What about vascular invasion? Did you have any? That is a key prognostic indicator regardless of grading.

Sereena - actually you can be Stage II without lymph node involvement - if the tumor is between 2 and 5 cm.

We have our own little "node nation"

Sereena - I am post-menopausal. I understand about the margins just not looking forward to chopping on a already battered breast again. I do have a question for you guys. I asked my BS why if there is cancer, even it is microscopic, in a node why they are not testing the other nodes? His asst said because they have found because it is so small the likelihood of my having cancer in the other nodes is slim...anyone agree or understand that? Also he has not scheduled any of the tests some of you have had like a bone scan or petscan. Is that something the oncologist does? He said some drs schedule breast MRIs but he didnt think I needed to have that done. Although my cancer is small it is close to the nodes. I see my BS on Tuesday and hopefully the oncologist next week if I can get in. Does the oncologist schedule the test to evaluate recurrence?

I had stage IIb with 2 positive nodes, 90% ER+/PR-/Her neg.  I was told the chemo would provide a 10% benefit with regard to mortality and recurrence risks, but since then I have found conflicting statistics that indicate it may have only been a 4-6% improvement.  I have had such severe side effects from the chemo that will most likely be with me long-term which have so adversely affected my quality-of-life that if I had  known how bad they were and had been offered the option of not doing chemo, I would have chosen to do only tamoxifen.  After finishing chemo, I started tamoxifen, but had such severe side effects that just compounded those left over from the chemo that I was completely nonfunctional, and so I stopped it.  I think if I had not had the chemo and had done only tamoxifen, I might've been able to handle the tamoxifen SEs, and it turns out that tamoxifen alone would have given me about the same risk reduction as the chemo.  According to statistics, the combination of chemo plus tamoxifen should have given me up to a 20% benefit, but statistics apply only to large populations and cannot be applied to any individual person. 

Also, the oncotype is validated for recurrence risk in node-negative, but my oncologist did suggest it could be used in my case, but I declined.... don't remember exactly what I was thinking at the time!  

On the positive side, my PET scan after chemo was cancer-free, so I do think the chemo did its job of killing the cancer, and am very comfortable with my decisions for declining further therapy at this time.  I think each person is an individual, and you have to weigh the benefits and the risks of treatment, and you need to listen to that little "inner voice" that helps guide you in making your decisions.  I tend to want a very low risk (less than 1%) with a very high benefit (greater than 10%), but people like my mother are willing to take higher risk for lower benefit (she wants that last 2%!! - and she is an 18-year suvivor!)  You need to be able to talk with your onc to discuss not only benefits and risks, but also quality of life issues BEFORE you start down a treatment pathway.  Best wishes and lots of positive vibes and prayers for all of you!

One thing that I learned during my chemo was that some chemotheray drugs don't target only fast-growing cells.  For example carboplatin (which I had) works on cells that are at rest.  So combining a drug that acts on dividing cells like taxotere with one that works on resting cells like carboplatin can be a good choice in some cases.

Also, PET scans etc are usually not given to stage I or II  due to unnecessary radiation and false positives