DX Score of 15 with LVI; cant decide to do Chemo or not

Sorry I can't help too much but one thing to consider is the mix of chemos being recommended and how many cycles. Did your current onc tell you this? Be sure to see which chemos both doctors giving opinions are proposing.



Some chemos are harsher than others and you can read about potential side effects of each. I believe the chances of other cancers are very small and many women have only mild side effects. There is a lot that can be done to minimise side effects.



No one wants to do chemo if they can help it and it is a hard decision for someone with stage 1 cancer.



You may even need a third opinion, or I have read of some ladies' cases going to a 'tumour board' for discussion. Maybe you could ask about that.



Wishing you well in making this decision.

That is a tough decision. My score was 16, no nodes, no LVI, but a larger tumor (just over 4th). My MO was on the fence w chemo, and got the opinions of her colleagues... She recommended 4 TC, because of my "young age" 43, my otherwise good health, the size of the tumor, and her practice uses "11" as a cutoff in otherwise healthy, young women.

I have 3 young kids and did everything in my treatment aggressively.

One Dr that I spoke to about concerns with chemo and the possibility of future cancers had a really good point. He said "but, you have a "known" cancer now, let's eradicate that".

Chemo was not a walk in the park, but, I'm thankful that I did it, and that it was offered to me. It has definitely helped me psychologically in this battle, to know that I left no stone unturned.

My non medical opine is that if I had LVI, I would have done chemo no matter what my Onco score was.  I had decided that due to the fact that if cancer cells were found in my vascular system, I could not fathom skipping Chemo.  You are ER and PR+ so obviously antihormonals are in your picture, but for me, LVI or a pos lymph node would have caused me to choose chemo.

While its a tough decision, thankfully you have the choice and can say yes or no, rather than the choice being made for you.

I agree with the others, get a second or 3rd opine from an Onco , any goood doctor will respect your decision to get other medical opinions and you'll feel safer in the knowledge.  I had 3 Onco opinons before I decided. 

Good luck to you , sending you wishes for strenght as you go through this.

Bevin

I also had LVI with an Onco score of 16.  My cancer was a little more advanced than yours and it is also ILC which can be aggressive.   I opted out of chemo after talking with 3 oncologists (one a very well respected integrative oncologist.)  I have been on Tamoxifen for 1.5 years and can only say - I hope I made the right decision.  It's tough but you are wise to ask questions and look for additional opinions.  You can't be too informed!  You should also check out Cancer Math at:  http://cancer.lifemath.net/

I have had the same questions as well and have had a hard time trying to research it and find answers. I have stage 1 IDC, grade 2, hormone positive and have LVI (multifocal)but negative nodes. I had a bilat mast with reconstruction the end of april and started chemo in july. I am half way done with the chemo (4 cycles of AC then 4 cycles Taxol) and am doing ok so far. I have had side effects but am dealing with them as they come. My other rec is that I also get radiation and I am so nervous about radiating my breast with an implant and the side effects and long term effects of radiation. I finish chemo 10/1 so have time to think about it, but am wondering if anyone else had these recommendations? I'm only 37 and have young children and don't want to make a wrong decision as I want to be as agressive as I can without compromising too much of myself. I can understand the use of chemo with lymphatic vessel invasion, just don't understand the use of radiation too.

My Onc said chemo was a must for me because of LVI, no matter what the score. I did not get a second opinion, accepted his advice, and did the chemo. 

LVI vs node is not about the type of cancer's responsiveness of one over the other.  It is about the higher probability that it may have traveled further out into the body through the bloodstream or lymphatic system instead of caught and stopped in the nodes.  In really simple terms, chemo is to get to cells in distant areas of the body before they take hold.

I had chemo because of my LVI situation and I have become a bit of an LVI obsessive since dx.

I discussed the significance of  LVI with every onc I met and it seems that, in all honesty, they are not terribly sure how to quantify LVI as a prognostic indicator. There are many women with extensive LVI but neg nodes. Conversely many women with +ve nodes and no LVI. One onc said "We think it is better not to have it than to have it but we cannot say exactly why - it is all guesswork." My surgeon explained in simple term's that they now have extraordinary microscopes that can easily identify the presence of LVI in tumours but they really don't know the significance with regard to recurrence risk.

Camilla,



I am late to this conversation. I am glad you made the decision to do chemo with LVI. You never want to second guess treatment later on down the line when it may be too late.



I did chemo in 2005/2006, it was tough but I never 2nd guessed my decision.



All the best with your treatment!

Hi.  I just came across this thread as well.  My Onco score is 23, I have LVI and family history.  I meet with my MO next week. I'm 55 years old.

Anybody with some input for me?  It is a very tough decision.  So far (before Oncotype test, which my MO didn't order, my BS did because it came up in a conversation...) my MO was emphatic about no chemo.  

Thanks and I'll stay tuned.

Omeggo, I see you're from FL too! I sent you a PM.