HER2- PR/ER+ What decides Chemo?

You can also ask your MO to run your stats through Adjuvant Online to show recurrence rates with, and without, various treatments, including tamoxifen. My understanding is that all people with ER+ tumors will be recommended tamoxifen or an AI (if menopausal).

Hi Bern, 

Per the NCCN guidelines, invasive cancers < or = 5 mm that are er+, her2neg, node negative:  "consider adjuvant endocrine therapy".  

If the tumor is > 5 mm it says to consider the oncotype test to determine further treatment plan.   

If you are leaning towards wanting more aggressive treatment, you may want to ask your doc if the onco can be run since you are right on the borderline, and it would help you make a decision.

Otherwise, the national guidelines are saying consider Tamox only.

Sorry you are in a grey area.  It sucks.  Been there (still there, LOL.). 

Bern25, for some reason, the SEs for tamox vary significantly by patient.  One of my friends, a 12+ yr BC survivor, had a horrible time; her MO said her SEs were the worst of any patient he had seen. In my case, I had some but they settled down after about four months, just like my doctor predicted. I remember asking my BS for her opinion on tamox and she said "Why not try it? You can always quit."  Afterwards, I thought that was the perfect surgeon's answer; they don't get many do-overs.  BTW, there are threads in the hormone forum on tamox SEs. As another member pointed out, keep in mind that patients who aren't having problems are less likely to post, since we often come here for support. (and there's a thread for women who didn't have many SEs). 

Hey, I was IDC 1.3 cm which was determined after they did a bmx, no nodule or vascular involvement.  I had an oncotype score of 23 which is right smack in the middle where two oncolgoists give you their recommendation and then you make the decision - JOY....Even though there is an Taylor study ongoing to people in the midrange oncogtype scores which will probably favor not being treated with chemo, I UNcourageously opted for the chemo and here is why. I'm 49, have two children under 10, I also work and just felt I had to throw EVERYTHING at this I could.  I just finished treatment six of CMF and have two left and I have to tell you, but for the first three days of nausea which some people are treated successfully for, and fatigue, I still worked, and thoroughly enjoyed every non-five-treatment days so it is doable.  HOWEVER, my first oncologist only recommended taxotere and cytoxan and that scared me but Sloan kettering in NY recommended CMF and it was a no-brainer b/c it's almost like chemo-light and felt beyond grateful that I had that option.  I'm a court reporter and TC  I think had the possibility of some finger tip nerve damage...how weird is that?  Anyway, pray and make you'll make the right decision.  oh ...I ordered a wig and never needed it...although I will have significant thinning after this treatment...but it will grow back..I'm also having my ovaries taken out during the reconstruction so will go on femara instead of tamoxifen..  peace....

Hello,

I will be going for a BMX on May 18th, after a lumpectomy which showed 3 small areas of micro-invasion and unable to get clean margins so I am choosing this route, My MO says no Tamaxifen as benefit does not outway the risk and if lymph node neg no chemo, no rad.so I too am confused as all of you, I will however be taking all my results post BMX as well as the tissue samples to be re-read for a second opion, this will be the only way I can have some peace (if there is any with this dx).  I just had the braca test done and they said the sample was too small for onco-type. Thanks for being there as this is one scary ride