Stage III but they say no chemo? Good news, but is it accurate?

Are you sure the Dr. said Stage 3 and not Grade 3.  It's easy to get the two confused.

Pat

Yep, I agree.  Unless your Mom is quite elderly or has some other sort of major health issue I would think chemo would be necessary.  Get a second opinion.

Take care,

Sharon

Yeah, I'm no bc expert but never heard of that....would get a second opinion.

i have to chime in here; your mom needs to get another opinion on treatment options. she can see another surgeon and./or oncologist. the protocol for stage three; large tumor and or lots of nodes is usually surgery...aggressive chemo...rads....hormone treatment if estrogen postive. i was 49 when diagnoosed and now i am 59. check this site on treatment options . glad you found this site and our boards* all the best*

Pink - they should know the grade from the biopsy; I don't believe they declare the stage until after the surgery; don't understand why they would say no chemo until after the surgery and they know all the specifics.  Did your mom have surgery already?  Lymph nodes removed and tested?

Pink - I don't think you have gotten a proper "first" opinion yet. The doctor sounded tentative, from your description. I think more needs to be known before you can get a clear message from the doc and THEN decide whether you are satisfied or need a second opinion.

Is the doctor a breast surgeon or an oncologist? Chemotherapy is usually decided on by an oncologist.

You should wait for the results of the tests and see what they mean before making a decision. A second opinion would most likely need those test results before counselling you anyway. 

Has she only seen a GP or surgeon so far? Sometimes they don't like to be the bearer of bad news. I can't believe that any oncologist anywhere would NOT recommend chemo for an otherwise healthy woman of your mom's age and diagnosis. Actually one thing she should ask when she sees an oncologist is if she can do chemo first and possibily shrink the tumor down before surgery.

Am a bit confused, topic title says no chemo, yet OP says doctor conservative, yes chemo...?



Nowords, i don,t believe the chemo prescribed was aggressive enough, just MHO, but then u say, you,re clear ? How long have you been out ?

I had neo-adjuvant chemo. My oncologist felt that the risks of damages far out weighed the potential benefits of doing tax after the AC. I was diagnosed 4/6/09, surgery 7/8/09, tamox 7/14/09, rads x 30 Aug. & Sept. 09. I had a team of Drs. at the Mayo Clinic. My PET was 7/09.

The breast surgeon thought that because of the extra nodal extension and my huge tumor that the PET would light up and that I had two years at best to live. After the PET...he said maybe I will be cured...the rads Dr. said that she thought I had ten years before it showed up in my bones. Who knows? No one.

I have had mammo as well as MRI on remaining breast, all clear. Chose uni-mast, as NED in remaining breast at that time and my risk for developing lymphedema was very high...did not want to have two arms compromised any sooner than I had too. I did develop it...in my right arm and I am right handed.

I had a mammo yearly from age 40, All clear,.... diagnosed at 50 with a tumor the size of a grapefruit. Cancer was estimated to be growing at least 10 years and never found. I found the changes....All the Drs. missed it...for 10 years....

 I am happy with my decisions. I had to find Drs. I trusted. The Mayo team was the second opinion.

For a long time I obsessed over stats and percentages for recurrence etc. It will either come back or it won't. When they do studies that focus all treatments on only my cancer cells I will trust the results to be absolutely pertinent, until then...it is really a toss up. Why does the same treatment keep some NED forever and others not?Why do some with a lower grade of cancer or no nodes, recur and die? Hopefully the time will come when the science exists to test each individual and create the cocktail vaccine that keeps them alive. I will need to deal with it if and when it returns...and I will...what choice do I have?

Make decisions. Trust your team or find a new one. Live life.

Long may we run...!

No words, thanks much for your post. My dx being somewhat similar to yours, except for nodes and tumour size, mine a mix of IDC and ILC, the fact that they say chemo did not work is a bit scary, how did they determine that ? They hit me with TAC...



You,re right, no choice, long may we live

At this point, a week feels more like a month because the waiting and uncertainity is so rough!  But in terms of gathering all the information (scans, biopsies, appts) it is still early to understand what the right plan will be for your mom. 

I like the suggestion of looking at the onc guidelines.  They may be confusing since you're still new to the terms and treatment protocols but that's OK.  It can stimulate questions which should be written down and taken to the next appointment. 

Are you participating in the appointments?  Or is the information you are getting is what your parents are verbally telling you?  It is very common, since this dx is such a shock to our emotions, that information is not absorded well and we hear what we want to hear.  Your mother is entitled to ask for the doc notes from all appointments along with the scan, blood and path reports.

If you are going to be involved then it would be a good idea for your mother to make sure your name is on the HIPAA form which allows you to have access to her records.

A second opinion is always, always a good idea.  Ideally, the second opinion just confirms the confidence that you've already bestowed in the first team of docs.  Sometimes it can be a completely different recommendation.  But the docs expect it and sometimes insurance companies will insist on it.  As nowords says - it's all about trusting the team and moving forward.  You don't want to look back with regrets.

(I am not Stage III but this thread is too intriguing to walk past.  I hope y'all don't mind if I tip-toe in here for a minute.)

I have to side with Athena on this:  let's not put the cart before the horse.  I suspect something got lost in translation, and sock's mom doesn't have a complete first opinion yet. She hasn't even had her definitive surgery, so the true size of the tumor and extent of node involvement aren't known.  Until that information is available to her medical team, everything else is speculation. 

If the tumor does turn out to be "4 - 5 cm" and there are multiple nodes involved, the medical team might recommend chemo. OTOH, an isolated tumor that is less than 5 cm and has spread to fewer than 4 axillary nodes but not elsewhere, and has not clumped those axillary nodes together, would be Stage II (not Stage III), wouldn't it? (http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-staging)

Here's what socks said in a recent post:  "...our oncologist started out by saying that she didn't want to use chemo unless absolutely necessary."  IMHO, that's something ALL oncologists should say.  No oncologist should be recommending chemo to a cancer patient unless it is absolutely necessary.  Not using chemo when it's not necessary is not a conservative approach to treatment.  That doesn't mean there aren't people out there whose risk of recurrence could be decreased significantly, and whose lives would be spared, if they had chemo.  (I had chemo, and I did just fine. I want to make it clear that I'm not dissing chemo.  Not at all.... especially for women with aggressive or advanced BC.)

So, even though waiting is sometimes the hardest part of all this, it seems like socks and her family need to have a long conversation with her mom's medical team to find out all the information available and what the options are at this point.  One step at a time, yes?

otter (heading back to her usual places)

I think once the surgery is complete and the exact tumor size is known and also the extent of axillary node involvement, the onco will be able to determine the type of chemo "cocktail" to recommend.  Before my own surgery my breast mass was measured at 4.8 cm according to the ultrasound.  The breast surgeon immediately knew that I would most likely have to see an onc for chemo.  Once the surgery was done the tumor actually measured 5.2 cm with 2 positive nodes out of 18 removed.  Definitely was recommended chemo.

Barb