I'm considering refusing chemo

She looked at my oncotype report and I showed her where it said I would gain 0% benefit from chemo and she said she felt like I absolutely still need it because of my age.

Wow and yikes, amyi - I wouldn't trust a doc that ignored evidence-based medicine to insist on a treatment with potentially dangerous SEs. I am glad you feel at peace about your decision. American medicine has a long way to go before it moves to responding to science rather than habit, financial gain or inertia - or whatever it is that motivated that doctor.

Here's a graph comparing node - & node+. I think it may pertain to only sentinal nodes though. http://www.oncotypedx.com/en-US/Breast/HealthcareProfessionalsInvasive/ClinicalSummary/ExpandedUse

I think all onc alway recommend chemo no matter what. I am one that refused chemo as I thought the risks out weighted the benifits. So far it has worked out for me. But it is a hard choice to make. I think my ocotype was 18 and I would benifit 4 percent. That was enough to convice me to have chemo.

I concur with Caryn. Icey, you cannot make such generalizations that ALL doctors recommend chemo. None of the three medical oncologists that I consulted recommended chemo. Furthermore, with your Oncotype DX score of 18, which falls on the cusp of the dreaded intermediate range, there still isn't enough evidence to determine if the risks of chemo outweigh the benefits. Once the TailorX trial is completed we will have more guidance with regard to our intermediate score sisters.

I'm so glad i found this forum. I was diagnosed last january and had BMX last feb 7. Stage 1 ,margins are clear and no node involvement. I had immed reconstruction with expanders. I met with my oncologist today to discuss my treatment options... My oncotype score is 20 which is intermediate. The decision is up to me whether to have chemo or not and just tamoxifen for 10 years. My oncologist said he strongly does not recommend chemo, he said it would lower my risk by 2 %.I am an oncology nurse who gives chemo to cancer patients but if you are in a situation like this it's really hard to make a decision. My husband is more on to NO CHEMO....I am confused bec I have read somewhere in this forum that chemo will reduce the risk by 3-4%. Which is which since my MO said only 2%....I am 37 y.o. and has 2 kids, I wanna be around for them...but I dont want to overtreat myself, I might not really need chemo but I dont want to blame myself for not getting chemo if "GOD FORBIDS", the cancer recurs. This is a very hard decision to make. I have seen the side effects of chemo from my patients and its not easy....I am not concerned about losing my hair. I just need help making the right decision.... CHEMO OR NO CHEMO,JUST TAMOXIFEN FOR 10 YEARS. I need inputs please.

Hi. I was diagnosed with stage 2 IDC three weeks ago today. I have yet to do any surgery or treatments. My MRI and PET/CT scans showed no swelling of my lymph nodes. We are now waiting on the results of my genetics test to determine if I'd have a double mastectomy (sorry I haven't caught up on the abbreviations yet) or not. If it's negative, the MO is suggesting that I go through half of the chemo first before surgery (to shrink the tumor) and then do lumpectomy with rads, then the last cycles of chemo. Now I'm glad I read this thread because I'd like to have that oncotype Dx test done and see if I'd benefit from chemo or not. Neither the oncologist nor the surgeons I consulted suggested this test done, and they both agree that I should do chemo first before surgery. I was so convinced that chemo was the only option. But now that I see I could be a candidate for this test, would you know if is this something I can insist on? I am still flip flopping between lumpectomy and mastectomy, and it's hard for me to decide on any thing right now. But I'd like to know if I'd have the option to avoid chemo even if it means more agonizing decision-making (I have only today finally convinced myself that a port would be better than not having one bec I though chemo is unavoidable).

TarheelMichelle...I am sorry to hear that you are now facing the challenges of having a DISTANT recurrence.  I do not wish to judge whether or not you chose the right course of treatment when you were initially diagnosed.  Everyone has to make the decision that is best for themselves.  And you are correct, with breast cancer, no one knows who will recur.

However, I wish to clarify a few points that you make in the event that new sisters come to this thread and read your comments.

You mention, your recurrence is NOT in your breasts.  Recurrence in the breast is considered "local" recurrence and is NOT part of the percentage equation when considering chemotherapy.  Instead, when physicians discuss with a patient whether or not they advise chemotherapy, they give percentages based on DISTANT recurrence, that is, metastasis, NOT "local" recurrence.  While it is true that the true absolute benefit of doing chemotherapy MIGHT be a small percentage, in terms of RELATIVE benefit, the percentage of benefit MAY be VERY GREAT.  Without a doubt, chemotherapy does sometimes leave patients with life long quality of life issues.  However, those QOL issues may be far better to deal with than ultimately dealing with organ metastases. 

No doubt about it, no one knows with certainty who will have a distant recurrence whether they have chemo or not.  But for many patients, keeping in mind there are 3 million Americans living with a breast cancer diagnosis, it is likely that chemo has kept many of those patients from recurring.

On a final note, there are many women who would not do chemotherapy unless their absolute percentage of benefit is a double digit number, while some would choose chemo for just a 1% gain.  It really comes down to an individual's risk tolerance for DISTANT recurrence. 

I wish you well.

I had a tumor <1 cm 100% ER/PR positive, but they found cancer in the Sentinel nodes (3/6) and after a second surgery found 2/14 axillary nodes positive. The margins on the tumor were extremely clear, so I wish to heck I could understand how a grade 3, minuscule tumor spewed cancer cells so easily! 

The MO explained it this way:The lymph system is like an interstate that runs the length of your body. My cancer had hitched a ride onto the interstate which means those nasty cells could be anywhere in my body. I opted for chemo.   

Continue to do your research and get medical options, but don't let the side effects alone guide your decision. Consider what you want as a final outcome from your treatment...whatever it may be. 

Treatment is a personal choice and the best way I found to decide was to do my research. Pubmed.gov is a database of worldwide medical literature covering alternative and traditional treatment research. It's medical literature so not written in lay terms, but still it's an invaluable resource. When well-meaning folks sent me info on various treatments, I looked them up here.



Also, every cancer is different in every person, it depends on the biology of the tumor and the person. My stage iv HER2+ liver mets have responded well to Taxol and Herceptin. Others have not been so lucky. So what works for one person, may not work for another. I look at statistical significance, i.e. what has worked for the majority when making decisions, and then I pray.



Quality of life is a big issue as well. At first Adriamycin was suggested for me, but my family has a history of heart problems. Ironically, my new life goal is to die of a heart attack, rather than a long, lingering death from cancer. We'll see what happens. But a big old life-ending heart attack would be a good thing in my book. I don't want it now, but I sure as hell am hoping for it later. Dying of cancer sucks. Bad.

Forgot to mention. My breast cancer spread via blood stream and I was stage iv right out the door, no recurrence. And, yes, I did get regular mammograms. Just my bad luck.

Also if you are hormone pos 100 percent then hormone blockers act as systemic treatment too and you can take complementary treatments to help with immune boosting and destroying cancer cells or preventing angiogenesis

Amy, did you continue on without chemo/radiation? How did you fare? I had a dbl mast.on Nov 29, '16. Am cancer free but now they want to give me both. I'm opting to say No and use alternatives. Did you?

amy1...sorry you are in this situation. We all had to make tough decisions. My advice is to get another opinion from a MO at a major university teaching hospital. Right now you only really have one since the breast surgeon is not an expert on chemo. Just remember that once you have gathered all the information you need, it is ultimately your decision. Good luck and keep us posted.

I was diagnosed in early march, found a lump and had a mammogram, ultrasound. Went to breast surgeon and had a core biopsy, it was cancer, had lumpectomy then a week later breast surgeon said when he was putting the dye in to see if nodes were good it stopped and another separate primary tumor he found.So went for a mastectomy. Pathlogy came back triple negative 2.7 cm. and a 1 cm her2 no node involved, went to fox chase in Philadelphia to see how to treat, they said with no chemo 80% chance it won't come back, but to take chemo that number will come up to 90%.should I take the poison that can cause other cancers like as in Robin Roberts case of abc news she got a a rare bone blood marrow cacer from her treatment.or what about heart problems, cancer of the blood you can development! What do I do 10% difference?

hi debs this is a very old thread but wanted to chime in to say welcome and take the chemo! Triple negative tumours are very aggressive and chemo/rads are our only treatment options. It can be sneaky and return so best to have the chemo to zap any stray cancer cells. Ultimately it's your decision but make it an educated one, do research and get a 2nd opinion (and 3rd!). I had 16 rounds of chemo for TN with a 2.2cm tumour. I completed treatment 1 year ago and am feeling great! Best of luck to you!