HELP ME UNDERSTAND??

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B123
B123 Member Posts: 730

If I am Stage 1 and ER/PR+ FSH -  IDC Right breast, having a masectomy to remove it. MRI nodes free..  Why would you have chemo?  I see many ladies on here with similar and having chemo?  Please help me understand.  I am told that it is a choice at this stage not a must.

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  • 37antiques
    37antiques Member Posts: 643
    edited August 2011

    Hello,

    There is a lot that goes into it, it is based on the tumor size, grade, etc, but many fall right on the line and can choose to have chemo or not.

    I didn't have a choice, but still would have done it, because I wanted to hit it as hard as I could, and because it travels through the bloodstream and not just the nodes.  If it's a personal choice, do what you feel is right for you, based on your tumor's personality.

    I hope this helps a bit.

    ((Hugs))

    Sue

  • carcharm
    carcharm Member Posts: 486
    edited August 2011

    What is your her2 status? This is a very aggressive cancer and can sneak past lymph nodes via blood and lymph vessels. Do you have lvi (lymph vascular invasion)? This means that the cancer has crossed into the vessels that carry blood and lymph all over your body. If you are her2 + then chemo is a must. If not than it's a gamble-you benefit from chemo because if there are any cancer cells outside the breast they could get destroyed yet the side effects -long term are dangerous. Thinks like MDS can develop down the road. I have constant bone and muscle pain that won't stop. I was stage I her2+++ so didn't have a choice.

  • Megadotz
    Megadotz Member Posts: 302
    edited August 2011

    Just a heads up that things can change after the final pathology from surgery.

    Pre surgery it looked like no chemo -- biopsy had shown 100% ER/PR + and negative HER2 

     My pre-surgery MRI showed no node involvement.  The post surgery pathology report changed my treatment plan. Postive node and lymphatic vascular invasion --- the cancer cells had started to move out of the breast.

     As others have noted, there a number of different factors to look at -  a lot of them aren't  known until post surgery.   The size, personality(hormone markers, grade,) node and vascular involvement.

    The main portion of the site has some great information for understanding what all this means. a good place to start is the "your diagnosis" page

    http://www.breastcancer.org/symptoms/diagnosis/

    A big portion of it is how comfortable you are with risk  and your personal medical history that lets you with the trade-offs with the various treatment options open to you.

    I hope this helps.

    It's challenging journey but there a lots of folks who've travelled the path here to help.

    Meg 

  • changes
    changes Member Posts: 622
    edited August 2011

    It doesn't just depend on the stage of the tumor, but also the grade. Chemo is not very effective with grade 1, because the cells act a lot like "normal" cells and aren't dividing quickly enough for chemo to kill them. Most oncologists use the oncotype score to provide some guidance on whether chemo is likely to be of benefit (or enough benefit to outweigh the risks).

  • Beeb75
    Beeb75 Member Posts: 325
    edited August 2011

    Age is a big factor too. Younger women benefit more from chemo.

    You may also benefit from an Oncotype test which will tell you your recurrence score and how much or how little chemo could help you.

  • Heidenia
    Heidenia Member Posts: 21
    edited August 2011

    Gals. Any thoughts in this...4 senitnel nodes clear but one "lymph node" didn't "feel right" so we'll know,in a week,if you will have radiation and chemo". How could a lymph node that is not the sentinel be the problem? Thoughts? Hugs to all. Heidi

    LCiS; mucinous carcinoma stage 1
  • B123
    B123 Member Posts: 730
    edited August 2011

    Thanks all for the input, I am Stage 1 ER/PR+ and HER-2  Grade 2, cribiform IDC with DCIS. My report from the U/S said Lymphovascular invasion present on one sight.  The tumor is 1.7, I am told by my surgeon and onc that no lymph nodes are involved per MRI and that it shows to be moving toward the nipple area only, via traveling ducts.  So far chemo is my choice, not a must.  Im very worried that it will be worse then it is, but the nurse in charge keeps telling me there is no reason to suggest that and not to worry.

  • B123
    B123 Member Posts: 730
    edited August 2011

    I am also told that this is a very well behaved tumor.. if that means anything.

  • Heidenia
    Heidenia Member Posts: 21
    edited August 2011

    Yes I heard this too. Why does the whacky diagnosis survey on this site not allow you to enter your real diagnosis? I actually have LCIS, DCIS and mucinous carcinoma all in one breast. I know. I'm not the only one out there. I. Tried to buy the app for is site and again you only get to pick one type. Any ideas on how to trick it? Xo

  • hrf
    hrf Member Posts: 3,225
    edited August 2011

    Heidenia, there can be more than 1 sentinel node so it is possible for 1 to be affected and not the others

  • gardengumby
    gardengumby Member Posts: 7,305
    edited August 2011

    I'd suggest that you get the oncotype test done.  That can help you determine your path better.  I had two lymph nodes involved, and had a "modified" radical mastectomy, but the oncotype was only 14.  With that my oncologist recommended no chemo, no radiation, 2.5 years of tamoxifen (which is kicking my butt bad enough) and 2.5 years of a (yet to be disclosed) aromitase inhibitor. 

  • B123
    B123 Member Posts: 730
    edited August 2011

    Im so happy for you that you had no chemo no rad! Im sorry the Tamoxifen is not cooperating with you though, I hear some saying that, and others are fine with it.  I think I would rather deal with that then Chemo though.  My ER/PR+ is greater then 90%, does that matter in the ocotype score?  I am DCIS IDC 1.7cm BRCA Neg Grade 2-3 and they say it is only in the breast. 

  • 37antiques
    37antiques Member Posts: 643
    edited August 2011

    Chemo is very do-able.  There are bad days, side effects, and some tears, but on the whole it's worth it and there are more good days than bad.  Most of us can continue to work full time and take care of all of our responsibilities during it.

    If it helps, according to the NCCN (National Comprehensive Cancer Network) hormone responsive tumors larger than 1 cm should receive chemo and hormone therapy, especially if it is an aggressive grade and or is a mixed tumor.

    Cancer travels through the blood system, node involvement or not.  With LVI even if only on one side, I would think long and hard, not just about what I feel like doing, but what is best for my long term survival.  Always remember, your medical team is there to help you, but they can go home at the end of the day and not give it another thought, so this is all about you.

    ((Hugs))

    Sue

  • Heidenia
    Heidenia Member Posts: 21
    edited August 2011

    Yes true. BS said 4 sentinel nodes clear and pme other node didn't feel right touch."

    And LCIS grade 2 and mucinous carcinoma stage 1 grade 2
  • mdg
    mdg Member Posts: 3,571
    edited August 2011

    There are so many things to consider and it really depends on complete pathology.  I was stage 1, ER/PR+ and Her2-.  My oncotype was 17 but I had angiolymphatic invasion (meaning there was a potential pathway established for the cancer to spread by blood) but had clear nodes.  I am 45 and have a young son.  I had two opinions...one said chemo and the other said no chemo.  I want to do everything I can to beat this especially for my son.  I knew if it came back and I had not done chemo I would have regret.  I am also pre-menopausal.

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