Chemotherapy or Radiotion?

Hi, Annie ~ Your post contains a lot of questions, but let me try to answer some of them for you.  

Early stage breast cancer is very treatable if you have the recommended treatment.  Surgery removes the tumor(s).  Chemotherapy is a systemic treatment that goes after any rogue cells that might have escaped from your tumor.  Radiation basically sterilizes the area where the tumor was, so that it can't grow back there.  Each tx step does something different, and taken together when you need them, they're extremely effective.

As far as a recurrence, what is much more troublesome than a local recurrence would be a metastatic recurrence, which means bc cells show up in your bones or an organ.  Unlike early stage bc, metastatic cancer can be controlled with chemo, but it can't be cured.  So you always want to throw everything that's recommended at bc the first time around, hoping that will ensure it's the only time!

Annie, you didn't give us your stats.  Are you Her2-?  If so, and if you haven't had an Oncotype-DX test (which you didn't mention), I would absolutely ask your onc for that test.  It's the only way to tell for sure if chemo will even benefit you -- unless you happen to be Her2+, in which case chemo and Herceptin would be recommended without the Oncotype.  

I know chemo and radiation and anti-hormonals seems like a lot, but try not to think about it all at once.  One step -- one decision -- at a time is a really good mantra right now.  I would concentrate on figuring out if chemo is actually recommended for you per that Oncotype test.

Hope this helps, and glad you've found BCO!     Deanna

Annie, from your data it looks as if you are strongly ER+ and Her2-. This is great news for you. Ask for the Oncotype. You don't mention your age, but at 43 I wanted 40 more years. The Oncotype helped give the full picture of how aggressive. While my tumor was 7mm (less than a centimeter) my reoccurance rate without chemo was 33%. With chemo it's about 10%. I look at the ratio this way. Reoccurence generally does not happen in the breast, so you need to swing with the big bat right at the start to keep the cancer out of bones, liver, brain. Oncotype gives you a reoccurence score and helps with the decision. When I look at your stats - 25% risk of terminal illness in 10 to 15 years looks a lot worse that a 5% risk of terminal illness in 10 to 15 years. I'm through chemo and rads and I'm still at 15%. But docs really don't know without the Oncotype score. Also ask if your office has a social worker or someone that help you take notes and digest the information your getting. Or bring a friend with you to all of your appointments. It is so hard to digest this information at the beginning.

Annie, talking to your social worker is a good idea.  Many women also talk to more than one oncologist, especially if they are not happy or comfortable with the one they're initially sent to.  Ask around for recommendations and consider making an appointment for a second opinion with a different oncologist if you are not comfortable with the one you've seen.

And don't be reluctant to ask questions.  If you don't understand something, ask for an explanation.  If they are rushed or impatient with you, seek out a doctor who isn't and who will take the time to explain things to you.  

Here's an explanation of the Oncotype-DX test:  http://www.oncotypedx.com/    I am really puzzled that your oncologist is recommending chemo for you without having done this, especially at age 61 vs. someone under 40, for example.  Normally, it's not up to your breast surgeon or radiation oncologist to decide if you need chemo, but in your case, I understand why they are also questioning the recommendation.     Deanna