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

I agree that the docs have not come up with suggestions and are still exploring. There is so much new terminology for you and your family, you may not have a full understanding of the implications. I had a lymph node biopsies but it was not removed for the biopsy - just the usual core biopsy with that long needle. Knowing that meant they did not do a sentinel node biopsy when I had surgery but did a full auxiliary dissection. For many, once the lymph nodes are involved, chemotherapy is usually recommended

I was initially told by my surgeon that it was very unlikely that I would need chemo.  

After they saw how much lymph node involvement there was, the plan changed quickly.

I agree with others that I think Dr.s try not to scare us too much at the beginning.  Saying "no chemo unless absolutely necessary" does not mean no chemo to me.   

Now, if she had surgery and there is a large tumor and lymph node involvement and they're still saying no chemo, then definitely I think there is a problem..

It's never wrong to get a 2nd opinion but I wouldn't jump to conclusions just yet.  

pfs34 (just seemed easier to type!) -

So glad to see you back and keeping touch.  I'm sure it very clear that many of us have clear ideas on what we felt was the best paths for our treatments.  I'm just wishing you and your mom successful results.  My fallback is the acid test -- knowing what I know right now, with the facts in front of me, am I doing anything that I may regret in the future?  If the answer is no, then it's the right path.

Just keep drilling those docs with questions!

Socks ... PLEASE ask your Mom to get a second opinion!  

Invasive and large with lymph node involvement would certainly indicate chemo. 

I was diagnosed Stage III & my tumor was 6 cm with suspected node involvement and I had chemo then surgery (bi-lat), radiation, chemo after radiation due to the fact that they found micro-mets in 3 nodes during surgery. I was 48 at diagnosis, not much younger than your Mom.

I'm also confused by a couple of things you posted: 

1.  All the receptors and stuff are positive, as well.  

I'm assuming the tumor is ER/PR positive.  Please find out if the tumor is also HER2 +

2. And when my mom had the biopsy, they only removed one lymph node and it tested positive. 

They took a lymph node during a biopsy?  I've never heard of that being done before.  Has anybody else heard of that?

I would like to urge us all to take a step back here... and not rush to judgment.  Nowhere does it say the doctor recommended against chemo.  NCCN guidelines strongly suggest chemo for tumors whose size and other characteristics qualify it as Stage III. 

 However, I would note that the continually evolving understanding of the biology of breast cancer is prompting increasing numbers of leading US oncologists to realize that, at least for women with highly estrogen-receptor positive tumors, chemo may offer very limited or no benefit when compared to hormonal treatments (aromatase inhibitors or tamoxifen).  See, for example, Harold Burstein's article http://www.asco.org/ASCOv2/Home/Education%20&%20Training/Educational%20Book/PDF%20Files/2006/Breast08.PDF

My tumor was IDC, grade 2 (Nottingham 7/9), 2 cm, highly ER positive, PR+, HER2-.  My Oncotype Recurrence Score came back at 17 (the highest number on the "low risk" range).  

My own oncologist - a top clinical trial researcher - was on the fence re the utility of chemo for me, even though I had one 2 mm met in one lymph node out of 60 (!) total.  "It's a gray area," she said. "Your benefit is likely to be in the 2-3% range."  To which my surgeon responded: "If this were the stock market, and you were being offered a 2-3% return on your investment, would you buy?"

The 2nd oncologist I consulted expressed her concern thusly: "We know that the overwhelming bulk of your benefit will come from the hormone therapy (anastrozole).  But to get this benefit, you have to take it for 5 years or more. Many patients have difficulty complying with this lengthy regimen, due to the onset of debilitating joint pain. While we are not 100% sure what causes this side effect, we know that doing chemo potentiates joint pain.  God forbid we give you TCx4 and then you are unable to stick with the anastrozole, which is far more likely to help you! For someone in your situation, I am inclined to think that the potential harm of chemo may well outweigh whatever good it may do."

So despite the micromet in one node, I didn't do the chemo. I'm on Anastrozole till the cows come home.

Many oncs offer chemo for reasons that may not have a lot to do with its actual utility: 1) it's what they know, and the idea that doing nothing may in some cases be better, or at least less harmful, than doing something is hard for them to accept; 2) the patient wants it, because emotionally she needs to feel she's left no stone unturned; and 3)hate to say it, but a very prominent oncologist admitted this at a conference I attended: oncs have a strong financial incentive to prescribe in-clinic chemo, it's where they make their money. 

What did my consulting oncologist say to me? "We know we treat 100 women <with chemo> to save 1 or perhaps 2."  

I believe that, 50 or 100 years from now, people will look back on our barbaric treatments... and pity us, much as we now pity those with cupping and leeches and such. The truth is that chemo is a shot in the dark for many of us. NOT the triple negatives - they get a clear benefit. But for those of us who are highly ER+, the utility of chemo is just much less clear! 

Just my .02 as ever!!