Node Positive and NO chemo...any of you ladies have input?

I am in a similar situation.  First they said my cancer was stage 1, but as I understand it when the first sentinol node tested positive, that changed me to state 2.  The grade had been 1, and I have not been told that, that has changed.  The surgeon took out 17 nodes after the first one was positive, and none of the others had cancer cells.  The tumor in the first node was 3.5 mm in size.  They did bone anc CT scans, and no cells showed up in any organs or in my bones.  I know that my cancer is receptive to both hormones, and so I am wondering if they will choose some kind of hormone therapy for me instead of chemo.  Since I had a partial, they will definitely do the radiation.  It sounds like they are taking out and killing any cance cells that may be remaining in my breast area, but I am worried that one or more cells may have gotten through in the bloodstream and travelled to some other part of my body.  Since it is supposed to be slow growing, it seems to me that it could take several years to notice symptoms of that having happened.  I was told that they do not follow up with more scans in later years, so I am afraid that I will always be wondering if one day the terrible news will arrive that I have cancer in some major organ or the blood.  From what I was told by my surgeon, the oncologist (whom I met briefly in the hospital but will not have an appoiuntment with until 2 m ore weeks) will put into some computer all of my stats and then tell me which type of medical intervention will give me the best survival rates.  Like he said she may say chemo gives you 4% recurrence and hormone gives you 3%.  Then they would let me decide.  Part of me says that the numbers are not significant to matter-just go with the one for which I will have the least side effects, but then I don't ever want to look back on this and say I should have picked the other one.  Any of you who have more stories to tell or advice I would appreciate hearing it.

bahamamom3, you don't mention your age or if you are pre-menopausal or post. These bits of information have a lot to do with your choices.  Also, you probably read about the Oncotype test.  Your MO should talk with you about this.  Even with one positive node, the test can be done.  That test will tell you and your doctor if YOUR tumor will respond to chemo.  Ladies with your stats do not have to always do chemo unless perhaps you are young... say 30-40ish then they will tell you to do the chemo because you are probably healthy and you shouldn't have got cancer to begin with (so to speak).  There is also family history to consider.

My BS explained to me in the beginning that way too many women were being treated with chemo when they didn't have to.  I would have NEVER taken the chemo route unless ALL THE CARDS pointed toward it.  Who the heck wants to over medicate themselves?  Early stages, low grades and nodes that would have never even been caught a few years ago because of technology are all good signs.

RADS and hormone therapy are definitely in your future and if you really want to see your stats, go to cancermath. com and put in all your information.  You can see for yourself the chemo versus no chemo route even without the Oncotype score.  Good luck in your decisions.

BTW,  I'm 47, pre-menopausal, my stats are below and my Oncotype was a 23.  2 nodes and a tumor that was hanging out very close to my axillary kinda left me with no choice.  I also have young children and although I tried everything (including getting a 2nd opinion on my final pathology from Johns Hopkins), to stay away from chemo... here I sit getting ready for my 3rd treatment of  TCx4.  Oh ya... kept the breasts... like them and glad I did ;-).

I thought the particulars of my diagnosis were going to show in the signature, but I don't see them. Anyway, the relevant part here is that I had one positive node, but elected not to do chemo.

They want to not starts rads and tamox right at the same time, so if there are unusual SE's there are less variables.

With 11 oncs agreeing and you living in one of the best medical cities in the world, especially for women's cancers, I'm assuming this is the new standard of care for this dx. They will test and scan again after treatment and chemo is always an option...since it is likely not a fast growing cancer you are in good hands..methinks! 

Hello all,

I am only halfway through reading this thread but I'm sure glad I found it!  I am considering no chemo, because the medications I take for HIV interact strongly/severely with most of the chemo drugs. 

My PCP said I could stop the HIV meds during chemo, but that scares me.  For one thing, he says my immune system is in good shape -- but that will change as soon as I stop the HIV meds, not to mention hitting it with chemo and all the stress of bc treatment.

Stopping the HIV meds would expose me to many risks, and and would require even more Neupogen shots (even if I don't stop the HIV drugs, I'll have to get more Neupogen shots than normal).  

My MO says if I choose to stay on the HIV meds, she would give me a much, much lower dose of T/C or I could do a low dose of CMF.  The side effects would still likely be significant, but fewer, but the efficacy would be much less, too.  The added reduction in risk of recurrence would be 6-7%.  If I stop the HIV meds, I think the risk reduction would be 10%.

She already convinced me to have ALND in case I couldn't tolerate chemo -- saying it would give me more protection against regional recurrence.   But all 15 of the nodes removed were negative.  She says hormone therapy is the most important part of treatment for me.  I can't find my path report that shows the % of ER+ and PR+ but one was 80% and I think the other was 70%.

I do have LVI and extracapsular invasion (is that the same thing?) and a Grade 3 tumor.  I was fully expecting more positive nodes, in which case I would not be as hesitant about chemo.

I am almost 55, and according to a recent HIV magazine, people in my situation have a life-expectancy of about 62.  I just don't know if chemo is worth it for me.  

I know none of you are in the same situation and I have to make the decision alone, but I would love ANY input you have. 

FOR ME.. I agree with Tappy and Elizabeth.., I turned 48 on the day of my first chemo.. I had 6tx of TC and had no problems... I had a microscopic positive node, but node involvement is node involvement in my book and I too have known or read about too many recurrances.. and I plan to live another 50 years, so I wanted to do everything I could... Etherize, I agree that you have too many other issues and could compromise your health.

Thank you TAPPY and bdavis, for your input!  I didn't realize I'd written a book up there.  So much to consider!  

It happened to me, but mainly because of my low Oncotype DX score. If it had been in even the questionable category I'd be getting chemo. I'm glad you posted this. People shouldn't needlessly suffer through chemo if it will not benefit them. I would have done it in a heart beat if the docs said I should, but I am relieved I don't have to.

Oh, sorry pinkchicago. No, It  have not had chemo. I am now on Aromasin and will start rads last week in January. There are numerous factors that went into this decision. My age, 63, low grade tumor, and Oncotype score. Also, the 2 nodes were minimally involved. I feel confident that this is the correct decision for me.

What did you decide?  I'm in a similar boat...

Pink... the hormone therapy basically caps the receptors from being fed by estrogen.. it won't kill the cancer if cancer cells have escaped.. only radiation and chemo kill the cancer cells... the radiation kills it locally and chemo kills it distantly... the hormone drugs will only help with the estrogen portion of the equation... and other things may feed a cancer... so I would say that if a cancer cell escaped to the liver and it was a highly estrogen fed cancer and you are on hormone therapy, it would slow the growth but not stop it... just as chemo would shrink it, but not kill it if it has already landed in the liver. Chemo only kills cells on route.

Chris-You might consider the SWOG 1007 study for node positve women with low to intermediate oncotypes.(If your oncotype score doesn't sway you)

Chris... one positive node is enough for me... better to be safe and have chemo.

I had a lot of fears about chemo and SE and in the end experienced very few SE, and took precautions... like icing my nails to avoid nail lifting, and drinking lots of fluids to help flush the toxins out. Of course there are no guarantees, but for me, I knew I needed to zap any rogue cells.. and I was willing to deal with some SE... chemobrain was also a fear, but I don't think I had any of that... but maybe I should ask my family... ha ha.