Have stage 2B....what will be next?

Agree with Kira about the oncotype test. My ONC recommended it for me because she was ambivalent about my treatment plan. I am so glad she did. My score was low and my cancer was not aggressive so I am doing radiation; however, my tumor was really small like less than a centimeter. I did have a micromet in the SN though but because of the test score she decided I didnt need chemo. I would ask my Onc about having the test done. It is very expensive but fortunately our insurance co paid for it - it is like over $4k. Keep us posted.  diane

OF course I am not an oncologist, but if you are stage 2b - given your tumor size of 2.5 cm, then there IS lymph node involvement, however small. Therefore, you will get chemo, I would think.

The oncotype dx test does not seem to apply to you: if you look at the  website (google oncotype dx and read the website about 'who' this test is for),  apparently it helps determine if node negative, estrogen postive early stage bc can benefit from chemo. The implication then is that node positive bc can benefit, there is no big gray area as there has been for node neg.  The whole point of oncotype dx test i think is to help prevent medical community from overtreating so many bc's (which they now do of course, since it can be deadly and it's hard to judge recurrence). For me personally, while chemo is scary, more scary is under-treating me.  I am the kind of person who wants to know that I brought all the guns to battle...I never want to be regretting there was someting I 'should' have done...Good luck

KSD not all stage IIB has lymph node involvement. I'm 2B with no nodes.

Kimberchick They typically give an oncotype test for early breast cancer (stages I-IIIA) that are node negative and HER2/nue negative. It sounds like you have micromets in your node so I believe you would still be eligible. The reason why they do this test is because there is a possibility you may not need chemo… the oncs really would prefer not to over treat some one. The test also takes into account your tumor grade (1-3). The higher the grade the more likely you will might need chemo but still there are many more factors to consider.

I didn't have the test because I am HER2+. HER2+ get herceptin which is more effective with chemo. The onco test is expensive so they don't test you if you are going to have chemo anyway.

I had 6 rounds of chemo (Taxotere, Carboplatin). Last one was Jan 18th. It really wasn't as bad as I thought. The last 2 rounds were harder but still doable. I was exercising all through the 1st 3 rounds. Slowed down round 4. Round 5 & 6 gave up a little but part of too was it was winter and cold out.

Hang in there and let us know how it goes.

I am 37 and also dx stage 2b.  My primary tumor was 2.2 cm and a had a micromet in each of the first two nodes.  My onc says he always recommends chemo for node positive ladies and that the Oncotype test is not applicable as soon as they find ANYTHING in the nodes.  I finished DD A/C x4 followed by DD Taxol x4 two weeks ago.  I had a BMX before chemo started (December 2010)and will be starting radiation in the next couple of weeks.  I will also take Tamoxifen for 5 years and then most likely switch to an AI for 5 additional years.  I have had a relatively easy time with all treatment so far and am willing to do anything that will provide ANY additional extra insurance against a recurrence.  I have 5 young children (10 and under) and want to be here for them for the next 50 years. 

Tammy

I don't know but I would think you could get the test with micromets. Good question to ask your onc. It doesn't matter if you are pre or post menopausal but you do have to be ER+. I really don't know a whole lot about this test because I was ineligible. It's a nice test to get though because I hear it give you more specific information based on your tumor rather than these general stats on stages.Push for the test if your insurance pays for it.

 I'm not that amazing. There are lots of women that did well and worked out all through chemo. Remember that people will post more about having problems than not having problems on this site.

I lost my hair. My eye lashes fell out 5 weeks after chemo but came in pretty quickly. The eyebrows thinned a little then started to fall out 5 weeks after chemo… but grew in about the same time so I never really looked like I was missing much. Just had to pencil in a little.  My avatar is a picture of me in my wig 2 weeks after my 4th treatment at a Bat Mitzvah.

I wore my wig that weekend only. Wore scarves all the time. They looked pretty good on me. Right now I'm almost 15 weeks out from my last chemo. I've been going without anything since week 13. I did have colored though. Its of course very short but I'm actually getting compliments from people who don't know I've been through chemo. Don't have the heart to tell them this is the most expensive hair cut I've ever had but I haven't needed a cut since mid October

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Mastectomy does not mean no radiation. I myself was in a gray area and surprised I didn't have to do it. Large tumors (over 5cm) usually do. Node invasion (not  sure micromets) usually do but depends on the number of nodes. Also your margins, how wide, where the tumor was etc. There are so many things to consider when it comes to radiation.

Iago you are right not all 2B is node positive: but the 2b with a tumor size of 2.5 cm apparently IS, and I got this info.  off of this very website we are on...they have a section describing what staging is and means, and for cancer size 2.5 cm, if you are called 2b it's because you also have positive nodes.

kimberchick: My opinion is that you will NOT have radiation if you had bmx. I had bmx, and my onc was like: No radiation. I said, "none?" He said, "None."  Then, "what is left to radiate?"  But then, I was considered node negative (isolated tumor cells).  If you are positive nodes in some weird circumstances I'm not familiar with I think there could be radiation but I wouldn't think with your small amount ie micromet that would qualify for the general, no radiation needed when there's a bmx.

KSD I'm not saying you aren't IIB, of course you are.  I'm just saying that within each stage there are many definitions. So many people think that stage IIB means you have to have infected nodes.Granted I haven't seen a lot of big tumor no node women. Even my BS was surprised I had no nodes.

I personally like the staging information on the NCI site here: link 

I'm stage 2b too, had bilateral mastectomies and am doing radiation. It was a hard call, but 2 radiation oncologists recommended it mainly because of my young age (35) and high grade of cancer. I'm having radiation to my chest wall only (in other words to my reconstructed breast). Some people also get radiation to the axilla (armpit) and collarbone area.



Depending on if they do the oncotype test on your tumor, and your age, I think you will be offered chemo and hormonal therapy. Radiation will be a harder call. A lot depends on how aggressive you want to be in your treatment. Will you want to do everything possible to keep it from coming back? Or are you willing to accept some risks to avoid some treatment. Best of luck in your decisions!

Hi

I had the same size tumor- was considered 2A and everyone thought I would not need chemo--oncotype came back in the gray area- so I decided on 4 rounds of A/C and radiation (had a lumpectomy)--never regretted it--- feel like I did it all--

Get your opinions, the oncotype then you will be able to make a decision.  Micromets are not necessarily the issue- but the oncotype can really help you.  For me, the micromets would bother me and I would probably have chemo--- but everyone's level of risk tolerance is different.  

You will ultimately make the right decision for you once you have your info.

judyfams - Lymph node involvement trumps oncotype.     If you have any LN involvement, they will strongly recommend chemo, as the "horse is out of the barn" as they say.... 

Hang in there - your type responds well to chemo - it's going to be okay.  I just finished chemo in November and honestly, the "waiting" wondering and worrying was far worse than the actual chemo medication! =:O  It can be done and you can do it!

I had a mx and am now doing 6 rounds of TCH, a year of Hercepting, to be followed by radiation.  I don't know for sure if it's because I had macromets in my nodes or extracapsular extensions but my onc said we have one chance to "cure" this and if we don't do it the first time, we are just treating after that so we're doing everything we can.  Period.  

I figured he knows better than I do so I'm going for it.   I also got 2 opinions from 2 different oncology groups, one from a major teaching hospital and one from a local onc who I chose to be treated by.  Same story from both.

Hi,

I also have stage 2/3 and estrogen and progesterone positive, HER2 negative. One lymph node was involved my tumor was 2.5 did have a lumpectomy. Had my first Chemo on Wednesday not so bad, I did have some stomach cramping though with mild headache. But was given drugs to take care of nausea which helps the cramping and headache as well . So all and all feeling ok. Still able to do what I usually do.  Can expect my hair to fall out on next treatment, feel pretty depressed about that. Depression is a problem at times. I don't really have a support system so I just try to suck it up and try not to have my own little pitty party. This might be a long haul. My chemo treatment is 1 time every 3 weeks by iv injection and it takes up at least 3 1/2 hours to start and finish. I will start radiation-5 days a week for  6 weeks in August with Hormonal theraphy later. Good Luck. Sherry