Any Stats on higher chances of recurrence for Grade 3 Cancer

The Oncotype DX test is now being done on ER+ Stage 1 and 2 tumors that have up to 3 positive nodes. The Oncotype DX test measures recurrence rate and need for chemo. Unless your mother has co-existing health issues, which I understand you believe she doesn't have, I would strongly recommend that the test be done immediately. It takes several weeks for the specimen to be analyzed.



What a great daughter you are! I wish you both the very best.

You should find out if she's HER2 positive or negative, ER positive or negative, etc.  There is much more to this than just Grade.  Grade 3 means her cells were more malformed than grade 1 or 2, and usually it correlates to a more aggressive cancer, but no, that doesn't mean she'll recur.  People of all grades relapse and people of all grades never see cancer again.

The good news is that the older you are when cancer is found, usually the more indolent it is.  Even though it's grade 3, it might not be aggressive in other ways.  She may not need chemo at all and can do very well with a mastectomy alone.

If she's HER2+, then she should do chemo and herceptin.  With a 3 cm tumor, there would be no escaping chemo here in the US, unless she was completely debilitated.  If she is ER+ but HER2-, they can do a test called an Oncotype which will calculate her risk or recurrance and chances of chemo helping her, based on her tumor type.  This only works for ER+ ladies and it sounds like she is since she's on Arimidex.

Chemo won't destroy her quality of life, especially if she is a healthy lady.  I sit in the infusion room and most of the women there are in their 70s and some 80s and a few 90s.   I'm often the youngster in my early 50s.  They all go home and tell stories about what they are going to cook for dinner and weekend plans the like.  They do just fine.  Sure, it'll make her a bit tireder than normal but she'll be okay.  

So, the doctor is wrong about quality of life (unless they have some completely different kind of chemos in Maylasia).  If you have a major cancer hospital there, that's where you should go.  And, herceptin is a must if she's HER2+.  That means her cancer is very aggressive but it can be treated with herceptin.

Good luck!  

I think others have spoken well to this fact, but the simple truth is, they just don't know what they need to in order to parse out who recurs, and who doesn't. Case in point is the newish Oncotype test for ER+, node-neg women.  (Edited to add: they use this in 1-3 pos nodes in some cases, but none of my doctors are prepared to do this, it's automatic chemo at my hospital.)

My doctor told me to expect an intermediate to high recurrence score based on my Grade 3.  Well, I turned out to be low.  It is only one of the prognostic factors, and my team recommended chemo based on my age (39 at diagnosis), grade (Oncotype is not considered as predictive in the grade 3 environment) and LVI on initial biopsy.  I went to three opinions.  I got "yes", "no" and "maybe".  Finally, one brilliant doctor said, "We just don't know what the best course of treatment is."

There is a lot of work to be done on cancer and recurrence.  Pinktober would like us to believe some get cured.  Truth is, 30+% of us carry the material that will make us recur and they just don't know why exactly.

This is not to say I don't believe in the correct treatments, I do. Chemotherapies and radiation definitely up chances.  Do vigilant homework.  When Voracious Reader is on deck, you know you are getting some of the best research you can, she's amazing!

My advice: get as many opinions as possible, and then charge ahead with an open heart for getting through and living life!

The risk of recurrence is higher for grade 3, but that extra risk dissipates after the first five years in studies. The fact that your mother is HER2 - suggests a less hard-to-treat bc; the pr-neg suggests less good prognosis, and the fact that the cancer is in only one node is much better than it could be.

In short, there is a mixture of things here and the truth is, no one can say, based on that data alone, what would be best for your mother. She may also have a choice of hormone therapy and bisphosphonate therapy in addition to surgery and radiation.

Adjuvant Online is more predictive for people who are BOTH er-pos and pr-pos - it is also more useful for pre-menopausal than post, generally. There are several cancer predictors out there. But remember that your mother is close to her life expectancy, so her mortality "statistics" are going to be different too.

My advice: she should do what she can live with, for better or worse. I know that's a hard decision!

Best of luck to you.