>80% (possibly >90) cure rate w/ surgery alone-Chemo Yes or No?

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>80% (possibly >90) cure rate w/ surgery alone-Chemo Yes or No?

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  • ConfusedandOverwhelmed
    ConfusedandOverwhelmed Member Posts: 4
    edited May 2012

    I met w/Onc yesterday & he gave me a >80% (possibly >90) cure rate with surgery alone, but still recommends I take Taxol w/ Herceptin.  I am 47 & his plans are to make me post-menopausal in order to put me on Arimidex.  I think this a pretty high cure rate - am I wrong - should I do it?

  • piopico
    piopico Member Posts: 4
    edited May 2012

    Hi C&O. I am also a recent 'diagnosis', and this board will be very helpful. But is that 6cm a typo? It seems large to be staged a 1. Maybe that's the specimen he removed? That's what mine was- a 6x5x4 but the tumor was 3cm.

  • pupmom
    pupmom Member Posts: 5,068
    edited May 2012

    Hi Confused, those stats don't sound right for Her+ without chemo/Herceptin. Hopefully some with Her+ will come along to help.

    Best Wishes!! 

  • ConfusedandOverwhelmed
    ConfusedandOverwhelmed Member Posts: 4
    edited May 2012

    It was a typo and as soon as I sent it, I saw it.  I have since fixed it.  It was really only 0.6cm which is about as low as you can be to even suggest chemo - according to the charts.

  • AlaskaAngel
    AlaskaAngel Member Posts: 1,836
    edited May 2012

    Hi C&O

    Until one is dealing directly with bc, one tends to think that medical treatment is rational....

    The confusion you have about the numbers is normal. With all of us being diagnosed with one name for the condition, it seems like the explanation would be simple. But the mutations for breast cancer are different among us all, and so "THE answer" (treatment) is very difficult to accurately use effectively with any given person. While the good news is that the vast majority of early stage patients (and especially those with cancers as small as yours) need no further treatment beyond surgery/removal of the cancer, the bad news is that no one can say for certain which individual persons will need further treatment.

    One good way to break the numbers down a bit more would be to find out just how much additional benefit can be had by doing 1) surgical or other ovarian ablation as an alternative to chemotherapy to achieve menopause, 2) radiation, if you are doing a lumpectomy, 3) hormonal treatment with tamoxifen.

    That still won't bring the number down to zero risk, but if you throw into the mix your own general health characteristics, you can see whether they reduce your risk even further -- such as including whether or not you are overweight, whether or not you smoke, whether or not you have the benefit of being a consistent exerciser, whether or not you eat an organic/healthy diet, etc. because those things do increase the risk of recurrence or reduce those risks.

    Even tiny cancers can turn out to have spread to other parts of the body, as others will also tell you, and at present there is no reliable scan or blood test to detect the tiny spread.  That is why (the "fear" factor), many with tiny tumors still choose to do all treatment possible.  It is a very individual decision to make.

    AlaskaAngel

  • Anonymous
    Anonymous Member Posts: 1,376
    edited May 2012

    Tough decision.  I would get opinions from different MO's if you are having a hard time feeling comfortable with a treatment plan.

  • leggo
    leggo Member Posts: 3,293
    edited May 2012

    I second what Susan said. Several opinions can make the final decision easier. I am surprised that your onc would use the word "cure". That strikes me as irresponsible.

  • dltnhm
    dltnhm Member Posts: 873
    edited May 2012

    If he is recommending Taxol then he is recommending a chemotherapy drug.

    Is it possible he was suggesting Tamoxifen which is a prescription drug that most women take for 5 years if they are ER+/PR+? That would make more sense to me. And the Herceptin would be because you present with HER2+.

    How exactly does he plan on making you post-menopausal? Are you going through menopause now? 

    I am also surprised that he would use the word "cure" because there is no known 'cure' for breast cancer.

    It appears you are in a good place, however, with your diagnosis and treatment thus far. Having chosen a mastectomy you have come close to preventing any reoccurence. Did you have a skin sparing, nipple sparing mastectomy? If you did, then that would be taken into consideration also.

    0 nodes involved also puts you in a much better place because it has not spread to the lymphatic system. Hurrah for that!!!

    Second opinions are not wasted time or effort :-) 

  • ConfusedandOverwhelmed
    ConfusedandOverwhelmed Member Posts: 4
    edited May 2012

    MO said we have 2 options, the first being Tamoxifen which could raise the chance of cure by 3-5%.

    The 2nd option and what he favored was doing the Taxol w/ Herceptin for 12 weeks and then Herceptin to complete a year.  And if that didn't make me post menopausel then he would either remove ovaries or put me on Zoladex, so that he could eventually put me on Arimidex which he though was better than Tamoxifen.  He also mentioned chemo would also raise my cure rate by 2-3% which doesn't seem like very much.  But I guess if there is a slight chance that anything escaped through the blood stream then the Taxol and Herceptin should take care of it.

  • momand2kids
    momand2kids Member Posts: 1,508
    edited May 2012

    my onc also uses the word cure-- her position was that I had the lump taken out and had treatement- therefore cured of that particular breast cancer.  I think a number of them see it this way because not everyone recurs. 

  • AlaskaAngel
    AlaskaAngel Member Posts: 1,836
    edited May 2012

    I too think using the word "cure" for breast cancer is risky and premature.

    If a person with your dx refuses chemotherapy, some oncs will prescribe Herceptin alone rather than with chemotherapy, followed by hormonal therapy. Insurance may or may not pay for it, and it is quite expensive.

  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited May 2012

    Do a search for Dancetrancer. She started a thread for patients with very small HER+ tumors. She put all the current research on the thread and got 3 opinions including MD Anderson. Private message her too. You will probably be able to make an informed decision after reading her thread!!!!!



    Good luck!!!

  • dancetrancer
    dancetrancer Member Posts: 4,039
    edited May 2012

    Thanks VR for the shout out! Smile  I did reply privately to momand2kids.  In case you hadn't found my thread that talks about all the research, here it is:

    < 5 mm HER2+ IDC...why NOT chemo??? 

    This thread is for < 5 mm, but you will see MUCH of the research covers < 1 cm HER2+ tumors which applies to your case.   I hope this helps - I fully understand your dilemma and completely empathize!!!   I waffled so much in making my decision....ugggh!  We are here to support you no matter what you decide, just make sure you are well informed before making that decision.  

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