Just diagnosed and received 2nd opinion

You don't say what kind of cancer (ER/PR positive or not) you have, nor grade, but stage II is scary, isn't it? That was where I was when diagnosed as well.  My oncologist wanted to do pre-operative hormone treatment as part of a trial - I said no, not because it would delay my surgery (my surgery was delayed as I wanted a specific doctor, so had the surgery as soon as she was available) - but I didn't want to be part of the trial because it would have meant that I would have weekly PET scans, and I didn't want all that radiation in my body.

I was diagnosed in October (2010) and had my surgery (mastectomy) in December of the same year.  The OncotypeDX testing was performed on tissue removed during the mastectomy.  Though I wanted a lumpectomy at the time of my diagnosis, I was not elligible for one (too much of my breast was compromised with DCIS in addition to multiple IDC).  Since then, I am thankful that I had to have a mastectomy, as with a lumpectomy radiation is required.  I was able to avoid both radiation and chemotherapy even though I had positive nodes.  From what I've seen of friends who experienced radiation, I (personally) am most thankful that I didn't have to undergo it.  I had reconstruction, and because I was able to avoid radiation, that went very smoothly as well.

You may want to investigate some of the SE's of radiation so that  you have more information on which to base your decision.  (Did you have any DCIS along with the ILC?)

Hi Blondie,  I'll share what I did.  It turns out I'm happy with my decisions.  I had the SLNB first, then chemo (neoadjuvant), then bilateral mastectomy, then hormonal therapy.  Having the SLNB first let me know what state the nodes were in before treatment, having the chemo before surgery let me know if it worked ( it did, very well ), the mastectomy was necessary due to DCIS on one side and my choice on the other. The downside is I will never know the exact size of my tumor(s).  Pre-op MRI was probably pretty close though.

The size of your tumor and perhaps your age if you are under 50 are probably what are behind the neoadjuvant chemo advice. I had neoadjuvant, but I also knew I had a positive node without a sentinel node biopsy. It was palable and biopsied via fine needle aspiration. With that situation, I did not qualify for Oncotype and straight to chemo I went. My second opinion said that it is not proven, only theoretical, that neoadjuvant chemo is advantageous over adjuvant, but that it does allow them to monitor the progress of chemo on the tumor. Otherwise, you are getting chemo and have no idea if it is effective on the tumor as it is gone from surgery. I liked that I could feel the softening and shrinking of the tumor. The doctors could not even find the lymph node after chemo. (However, as you'll see below, they were bad anyway even if not enlarged.) I was told that there was no way that the cancer could spread during chemo. I don't know if that is true or not, but that is what I was told. Good luck with your decision.

I did it all because I had positive nodes (as you can see).  For me, knowing my strength and physical ability, I felt I could handle it all. Not everyone can or wants to take a risk for a possibly small % in survival, but I did--and recovered with no lasting side effects.