Considering no rad, no chemo, no hormones

Hi Christina, sorry it's been over two days and nobody has bothered to respond to your post. Hope you you're not taking it personally - it's just that very few people choose to only have the tumor surgically excised and then do nothing further and those that do might be hesitant to admit it here. I'm one of those rare individuals, but I don't have any qualms at all about saying so.

You don't mention how old you are or other important things like history or how wide those clear margins actually are.  I was just a week into being 49 at my diagnosis, but already in natural menopause. Unlike yours, my tumor was just a grade 1 and just barely 1 cm and very non-aggressive. No family history and very non-dense breasts. Although it may not seem like such a major difference in size or grade, it could very well be a horse of a totally different color as compared to yours in terms of risk. So what's working for me might not be such a great idea for you.

It's not exactly true that without lymph node involvement there's no chance it might have spread when the nodes that were tested are found to be negative. However, negative nodes makes it less likely. On a molecular level, some grade 2 cancers act more like non- aggressive grade 1's - but some are very aggressive and act like a grade 3. There's been some research that suggests that all tumors should be classified as either grade 1/non-aggressive or grade 3/aggressive and that the grade 2 category should be eliminated.  Unless you get an Oncotype test done, you're probably not going to be able to get much of a handle on which kind of grade 2 you have and that would be information important to know before making a decision to decline adjuvant therapy. If you've got an aggressive grade 2, additional treatment would make more sense.

Most breast cancers will not reoccur either locally or distally if they've been removed with wide, clear margins by a surgeon using good technique. It's because of that percentage that will, and because no research has yet been able to positively ID ahead of time who will and who wont, that everyone is being treated as so aggressively.  When you have a non-aggressive tumor, the risk of distant mets are minimal and a local recurrence of that same cancer doesn't pose as great a risk as it would in a higher grade tumor. Different story though, if it's aggressive. You want to avoid recurrence of aggressive cancer with no holds barred  - especially if you're someone who might regret not doing everything possible should it come back at you later (and sometimes sooner than later). If you're not that kind of risk adverse person and you're willing to accept a certain level of risk in order to avoid additional treatment, then in not doing anything else it's quite possible you might never have to deal with it again...or maybe you will.  There's just no way to know for sure. You've really, really have to know and understand exactly what kind of cancer you're dealing with though, before making major decisions to decline treatment.

You mention wondering about treating any possible recurrence more aggressively if and when it happens and just treating conservatively now. With my situation, I wouldn't do anything differently if there's a next time with a local recurrence. I expect, in not having done anything to alter the DNA (radiation, chemo, hormonals etc) that a local recurrence will likely be the same non-aggressive cancer.  I would however, have a mastectomy if a recurrence was more aggressive and I wouldn't hesitate to use hormonal therapy and or possibly chemo if  I developed metastatic disease. Personally, I would never allow radiation even if my tumor were more aggressive or larger unless there was no other way to eliminate some known residual tumor or if needed palliatively to control pain.

I'm not into lifestyle changes - or any kind of alternative treatment. I haven't changed a thing in my life since I was diagnosed over 7 years ago. Actually, I did change one thing - I now make sure to get my mammogram faithfully every year.  

Christina,

Treatment decisions are so hard and unique to each person.  I encourage you to gather all the information you can.  Hormone receptors, OncotypeDX, Ki67%, HER2 ....

The onc I had my second opinon with said this "Now (early stage), is our only chance to cure this disease, once it's spread there is no cure"  So don't think you will treat aggresively if you get a recurrence, it might be too late then.

 Good Luck to you on your journey

ChristinaS - Sorry you have to be one this journey.  As mentioned by others, get all the information you can on your cancer before you make the right decision for YOU!  Also, get a second or third opinion from oncologists who are from different backgrounds if you can.  For example, a combination of oncologists from a cancer/research center, one who is not, one who is open to intergrative medicine, etc...  Before you meet with them try and do some research on your own so you can ask questions about your cancer, the different options and treatments, etc...  Be open to hear what they say and bring a loved one with you.

After you get all the information about your cancer and the opinions of medical oncologists you can make a decision which is right for you.   Remember each cancer is unique as each of us is unique.  Some people and their cancers respond differently to different treatments, both conventional and alternative.  This is your body, you need to make the decision with is right for you.

Best wishes to you and this site is a great source of support and a place to ask questions. 

ChristinaS,

Clcik on the Diagnosis and Symptoms link at the top of the discussions page.  It will get you to some good resources on the main site.  These should give your information about the various measures.  Cancer.net, Cancer.gov, Cancercare.org and Livestrong.org also have some good resources.

It's a scary situation,  so make saure that you're making an informed decision.

All the best.

Meg

No nodes, clear margins, that's great - but, still, bc cells could have spread. I'll never forget my onc saying - metastases are like thistle down blowing in the wind - tiny, invisible, you have no idea where they might have blown. Stage 4 is incurable.

I like you am stage 2 (2b). My tumor was very large. I had no nodes clear margins, everyone was jubilant and amazed, laughter all round at my pathology report. But still had the full monty and very glad of it. I heard what my onc said loud & clear and he only had to say it once.

Look after yourself well and carefully, and best of luck.

Arlene