Considering No Radiation, HRT & Chemo post-op

Options
Miles2Go
Miles2Go Member Posts: 120
edited June 2014 in Managing Side Effects of Breast Cancer and Its Treatment

Successful Lumpectomy 10/18/2011 for Stage 1A (Invasive Lobular CA), 8mm Tumor, Negative Sentinel Node Biopsy.  Long blonde hair, high heels, inside-sit-down-daytime job & do-not-look-my-age 72.  If you have or are considering or have considered "no treatment" treatment option beyond surgery, your thoughts?

· Share on FacebookShare on Twitter

Comments

  • Leah_S
    Leah_S Member Posts: 8,458
    edited October 2011

    Miles2Go, with the results you've given so far it's unlikely chemo would be recommended unless you have a very high oncotype. Rads would probably be recommended since you had a lumpectomy. I think the local recurrence rate is over 30% if you don't have rads and about 7% if you do (but please please check those figures since we're relying on my memory here).

    I am unclear on what you mean about the HRT. Do you mean you've been on HRT and want to continue or you've been on HRT and want to stop? If "hormonal treatment" has been recommended for you for post-BC, then that's not HRT, which is hormone replacement therapy but an AI, an aromatase inhibitor. It prevents the development of estrogen (from adrenal glands and fat cells). A more accurate description would be "anti-hormonaltreatment".

    I suggest a long talk with your oncologist about the pros and cons of each of the suggested treatments for your case specifically. You obviously still have a lot of questions and you deserve to have them answered fully.

    Best of luck. Let us know what happens.

    Leah

    · Share on FacebookShare on Twitter
  • Miles2Go
    Miles2Go Member Posts: 120
    edited October 2011
    Leah, Thanks for your response.  To clarify, I've been taking one form or another of Estrogen (primarily patch for decades) and Progesterone (pills) for 30 years.  Now I understand the difference between HRT and AI anti-hormonetreatment, thanks!  Only recently did I realize the correlation between my age (72) and breast cancer statistics.  I will listen to my surgeon, my oncologist (local hospital), and a new internist "hired" 3 weeks ago who was the first MD in 15 years to question my still being on HRT RXs followed by when was my next breast x-ray (already scheduled a week later).  I understand your survival statistics for my specific diagnosis and pathology are correct.  There are practical matters influencing my choice to skip adjunctive therapy (another time).  Will let you know when the other shoe drops.  Thank you for writing!  Colorado Morning Glory
    · Share on FacebookShare on Twitter
  • suzieq60
    suzieq60 Member Posts: 6,059
    edited October 2011

    Mile2Go - do you know if you were HER2+ve? If so, which would be very rare (like me), then chemo and herceptin are the standard treatment. If not, chemo would probably not be recommended for your size tumour. Also, how high were your hormone receptors? If they were low, then no hormone treatment would be required. This information should be on your pathology report. My ER and PR receptors were both over 90% - I had been on HRT for 4 years - I am now on Arimidex. Definitely radation is necessary as you had a lumpectomy - it a relatively easy thing to go through - I've had it on both sides.

    Sue

    · Share on FacebookShare on Twitter
  • tarry
    tarry Member Posts: 156
    edited October 2011

    Recent studies have said rads do NOT benefit women 70 and over under certain conditions. I think it is all on the National Cancer Institute site. Goggle should bring it up.

    Here's the report:

    http://www.cancer.gov/clinicaltrials/results/radiation-older-patients0610

    · Share on FacebookShare on Twitter
  • Miles2Go
    Miles2Go Member Posts: 120
    edited October 2011

    Thanks Tarry, Susie, and Leah! for sharing information with me.

    I see my surgeon and oncologist on Friday, 28 October; getting a copy of that path report.  Will listen,state my 4 magic words, "We'll think about it."  We because I will be accompanied by my husband.Been preoccupied as my husband was diagnosed with acute Crohn's Disease and ER hospitalized , 4 days prior to my 18 Oct BC surgery~been a bit overwhelming; he passed on surgery and has begun Remicade (there is no cure for Crohn's Disease).   Sometimes it is a challenge to see 3 good tires on your car when one of them is flat!  My anology to life at the moment.  Thanks again; will be back after more information :)

    · Share on FacebookShare on Twitter
  • suzieq60
    suzieq60 Member Posts: 6,059
    edited October 2011

    Miles2Go - good luck with your doc consult - I hope you get a lot more information and can decide on the best treatment path. Hugs to both you and your DH.

    Sue

    · Share on FacebookShare on Twitter
  • Miles2Go
    Miles2Go Member Posts: 120
    edited October 2011

    Thanks, Sue.  Visited Woomera AB north of Adelaide (work trip).  Always wanted to return to see Glenn Elg~ The hysterical part of what's going on with me is after 30 years on HRT, I'm experiencing hot flashes for the very first time in my life!  Why 30 years of HRT?  Short story is my surgeon suggested I continue after DCIS 15 years ago because I was on such a low dosage; no physician since then (except a Unversity doc I "hired" & saw a week prior to my most recent breast X-ray questioned the HRT, although I've seen internists regularly for the past 15 years). I simply didn't understand the correlation between continug HRT and aging.  The trade off is I look great with solid bones~for now!   Just when I think I've got all of my ducks in a row, some errant duck wanders away.  Will let you know when the other shoe drops.  Colorado Morning Glory

    · Share on FacebookShare on Twitter
  • Miles2Go
    Miles2Go Member Posts: 120
    edited October 2011

    . THE OTHER SHOE DROPPING...post-op pathology.

     Diagnosis Stage 1b.  Pathological Staging N1mi.

    ü  Invasive Lobular Carcinoma (10% of the population, Early diagnosis)

    ü  Tumor Size 1.0cm (small)

    ü  Grade 1 (slow growing)

    ü  Estrogen Responsive (ER)  92% 

    ü  Progesterone Responsive (PR)  40%

    ü  KI67  10% Intermediate (low)

    ü  HER-2/neu - Not Amplified 

    ü  THE SURPRISE;  Two Sentinel NodeBiopsies; one showing minimal micrometastases, 1.1mm

    ü   Clean Margins (1 cm)

    ü MX -  metastasis can't be evaluated.

    Gene expression OxcotypeDX ~ to be determined by test ordered 28 Oct 11 (I requested)

    ~test will determine aggressiveness growing tendencies of micrometastases.

     So!  Waiting for yet another shoe to drop!!!  Hugs to Everyone, Colorado Morning Gory

    · Share on FacebookShare on Twitter
  • suzieq60
    suzieq60 Member Posts: 6,059
    edited October 2011

    Miles2Go - Good news you are not HER2+ve and low grade. Intereresting to see your ER reading - I was told high ER percentage can indicate it was caused by HRT but it's just a theory. Not good news on the micro mets in the nodes - hopefully the oncotype test will give a direction for your docs to follow. I took HRT to prevent osteoporsis too - aren't the hot flushes awful. Looks like they will recommend Arimidex seeing your hormone receptors are high - the hot flushes will be worse on it but I see it as a sign that it's working and try not to complain. Hope you don't have to wait too long before you get the results.

    Sue

    · Share on FacebookShare on Twitter

Categories