Does Everyone with IDC have Chemo

i think it depends on your stage, type, grade, etc. plus your oncotype score - this is a fairly new test that shows the benefit of chemo to you. before this test was available, they would throw chemo at everyone because there was no way to tell who would benefit from chemo and who wouldn't, but now quite a few women are not doing chemo based on their oncotype results. I did chemo before surgery (neoadjuvant) because of my stage, and did not do the oncotype test - maybe others on the board who did the test can explain more?

I also had a 1.7 cm IDC, grade 3, no nodes, barely ER+.  I chose no chemo even with a high Oncotype score.  It's an individual decision and much depends on your overall general health, age, etc.  I am 60 and have Type 2 diabetes and chemo could have caused long-term side effects that I considered very dangerous.  Do your research, understand your options and make the decision that is right for you.

Hugs,

Michelle

Deb - I forgot to mention, but yes, I also had lumpectomy + radiation in addition to femara.  I was 50 when diagnosed. Age I think is also a factor -- if younger, chemo may be additionally helpful. In my case, the % risk reduction with chemo was something like 2-3% (I think?) and I decided to take the risk.  your oncologist will go over risks etc with you and you may have the *choice* to decide on chemo, like I did, or you may not have a choice in the matter. in some ways, a choice is more difficult but one bit of advice is to select a choice that you will be comfortable with.. i never felt bad about my decision..... best, embee

I did chemo but thought I'd throw in my 2 cents because of my choices since then and the results. When I was diagnosed, the HER2 trials for Herceptin hadn't reached any conclusion yet. I was considered high-risk because I was HER2+++, and with a tumor over 1 cm at the time even though my hormonal status of ER95%, PR50% helped enough to significantly reduce my risk, I ended up doing the chemo. If I knew then what I know now I would have refused it. As someone else mentioned, younger patients get more benefit out of chemo, and I was diagnosed at age 50. There was no Oncotype Dx when I was diagnosed, and even the aromatase inhibitors were still only recommended for use for those with mets. Even with a high Oncotype Dx I would have refused it, knowing what I know now about hormonal status. Anyway, here's my signature, just to throw in for consideration when you get your results back.

A.A.

Hi DebRox,

Chemo recommendations depend on much more than just the type of tumor (IDC).  Here's a link to the NCCN Treatment Guidelines for Patients, which are considered the "gold standard."   It's based on the latest consensus of experts and evidence-based research.  Even so, depending on your particular (specific and possibly unique) circumstances,your recommendations may be different.

And of course, recommendations are just that  - guidelines.  The best we can do is gather facts, talk with experts we trust, explore options, and then make choices to best balance our personal risk versus benefits.  It's hard, but try not to get ahead of yourself.  It sounds like you're doing much better at remaining calm and level-headed than I was at that stage in the process! Ask lots of questions here - it's great to discuss things and get lots of food for thought, but wait for more objective details before you get too "attached" to any particular course of treatment.

Best of luck!  

Hi DebRox,

Oh, I definitely know what you mean about wanting information and knowledge - it's me to a "T!"

My receptor pathology is a lot different from yours, but I'm sure others will chime in about that. It sounds like you're going about all this very methodically and sensibly. You'd be nuts not to be scared, but you'll be surprised how much strength you'll find to deal with this, especially if you keep taking it one hurdle at a time.  

Someone on this board (wish I could remember who, so I could thank her!)  said, "Keep your head where your feet are," and I try to remind myself of that whenever I start to flounder.  Hang in there, and let us know how you're doing! 

Deb,  One more thing for you.  A group of us went through treatment together that started last June.   Someone gave us a motto  and it really stuck and has gotten me through some pretty tough days.  "YOU DON"T HAVE TO BE BRAVE< YOU JUST HAVE TO SHOW UP!!!!!!

Hi Ginny,

That's a good motto too!  We need all the affirmations and positive mottos we can get :-D

Also a great point to mention to DebRox about the treatment-starting-in-whatever-month threads for camraderie and support!

Take in all the information from the doctors and the pathology report, and remember that the treatments of surgery, chemo, and radiation each have their own set of risks both short term and long term that you need to take into consideration in your decision making process.  Make sure that you understand each of those risks before you choose the treatment constellation that is right for you, and always remember that the final decisions about treatment rest with you.  No one can or will force you to do a treatment against your will.   

Also make sure that you learn the difference between absolute risk or benefit vs. relative risk or benefit.  It can distort things if you don't understand it.  If a treatment is shown to help 1 in 100 women, and another treatment is shown to help 2 in 100 women, the second treatment gives a 50% reduction in risk over the first treatment even though is only benefiting 1% more women.

@Liane.....you did not have your lump removed?

Hi Ladies,

Bdavis, I'm in the same school of thought as you are and decided to throw everthing I got at this disease including alternative medicine, I take lots of supplements (told onl what I take and he approved), go for healing, reflexology, massage, also doing FEC chemo with herceptin. At least then I feel I've done everything within my power to heal myself. Also I haven't experienced really bad SE the first night was really bad and I was sick, then 2 days ago I had my period which made me feel bad for about a day, but since then I've been fine I'm on day 11 now.

My lump is large and I'm at Grade 3 with lymph node involvement although I dont how involved, had results back from my bone scan and heart scan both clear, just waiting for CT scan results, so hoping and praying it has not spread anywhere else, will the CT scan show how involved the nodes are?  The plan is chemo first (just finished my first round once every 3 wks) then mastectomy, then rads.

bdavis

Hi No surgery at all yet just started chemo, they said it was in my armpit as they could see from the MRI scan on my breasts obviously still dont know how many nodes are involved, the grade was done by the 2 biopsys one on the lump in my right breast and the other on the lymph nodes. 

DebRox... I meant to add earlier (since someone mentioned cold caps) that my onc did not want me using cold caps. He said that mets can go to the scalp and using cold caps can prevent the chemo from working properly on the scalp... so if that is something that you would consider, please discuss it with your doctor... Saving your hair isn't worth risking your life... in my opinion.

I also was IDC stage 1, onco score of 20 and decided to have chemo.  I was 67 last year at time of diagnosis.  I decided to do chemo because I found out that breast cancer mets to the liver, lungs, brain and bones and did not want to take a chance with those organs getting cancer.  I had 6 rounds of taxotere and cytoxan and felt that I had no problems doing it because of my diet.  I totally changed my diet to many small meals of high protein, lots of organic fruits and veggies, soups and a lot of water. No processed or fast food.  Rested and did not push the doing of shopping, laundry, cleaning etc.  Had friends and family help with that.

I am now on an antiestrogen drug called Fareston as I refused to take any aromatase inhibitor due to the side effects.  There is a thread here about Fareston.  I don't know why this drug is such a secret.  It costs about the same as Tamoxifen and is a SERM like Tamoxifen but with fewer and less severe side effects that Tamoxifen.  I too have had no problems with Fareston.

Whether or not to do chemo is a very personal decision that you alone should make with all your research.  One question to ask yourself is how would you feel if you did not do chemo and in a few years had a recurrence.  I just decided to give myself the best chances - did chemo - and if there is a recurrence - then I did all I could and would still have no regrets!

Judy

bcdavies,

I live in Ramsey, NJ.   Had surgery and chemo at Valley Hospital and radiation in West Nyack, NY. Where in NJ do you live?