No other treatment after BMX?

wandawoman · October 2013

I was diagnosed July 3rd with IDC, tumor size 5mm. I had a BMX August 8th with tissue expanders placed the following week. I was diagnosed with stage 1a, grade 1, SN biopsy -0/2, ER/PR+, HER2-. In the past month I have seen two oncologists who say the same thing. No chemo, No radiation. Understandable. But also, that hormone therapy (tamoxifen) is not recommended for my stage and grade of cancer. They say I fall into a "little box". That I could get 1% reduction in recurrence rate (current recurrence rate at 5%) but I would need to weigh the benefits of that 1% against the risks/side effects of taking the medication. Has anyone else been told this? I see many stage 1's posting who are on hormone therapy and just wanted to know if you had been told the same thing?

doxie · October 2013

Did you have an Oncotype done on your tumor? This may make a difference. Interesting if it was not sent out for testing. You might request that is it was not done, as your "third" opinion. Also no harm is seeing how you tolerate tamoxifen. Still you need to consider that the SEs may outweigh the % benefit.

wandawoman · October 2013

Thanks Doxie. I don't remember anyone mentioning an Oncotype. I will check the pathology report to see it it is on there.

Anonymous · October 2013

Same here. Almost exactly the same diagnosis. I also saw 2 different oncs. Both felt that in my case the risk of SE's from Tamoxofin outweighed my risk of recurrence. No oncotype was done. Logically I can agree with the treatment plan, but it is still scary. My first onc actually told me to have a great life and he did not need to see me again unless I have a problem. !!!!!!!!! My second onc is happy to monitor me every 6 months or so. She understands I just need a little bit of security in feeling like SOMEONE is keeping an eye on me.

MNSusan · October 2013

Same here but I had Mammaprint done. Results were low risk for recurrence. I did Tamox the first time around and had lots of SEs, so I was happy not to do it again. IDC, Grade 1, Stage 1a, no chemo, no rads, no hormonals. I am monitored annually with blood work only. After seeing docs so often for so long, its weird but I'm good with it.

wandawoman · October 2013

Dulcigirl- my first oncologist also told me I would not have to see him again...this of course spurred the 2nd oncology consult because I just couldn't wrap my head around the idea that I had been diagnosed with breast cancer, had bilateral mastectomy and now I didn't have to see anyone? The second oncologist also said he would follow me every 6 months. I definitely don' t want to take meds that I don't need, it's just scary for me.

MNSusan- the oncologist said there were no random scans, just make sure I keep up with my annual physical and gynecological visits.

theresa45 · February 2014

My tumor was .6mm ER/PR+ Her- Stage 1a Grade 1 or 2 (one oncolgist said grade 1 another said grade 2) and no positive nodes. My ki67 was <20%. My oncotype score was 14. I had bilateral mastectomy and radiation due to a 1mm margin to the chest wall. I've been on tamoxifen for 4.5 years. Both my breast surgeon and oncologist recently told me that they want me to continue on tamoxifen for 10 years. I was looking forward to stopping after 5 years. I was diagnosed at 44 years old and am now 49. I'm still premenopausal. I have a strong family history of breast cancer, but am BRCA negative. My ki67 was >20%. I'm just providing my information for reference since we all have small, hormone-sensitive invasive tumors.

Msjackiefan · March 2014

Hi, wandawoman,

My dx is very close to yours, almost identical. I was checked for oncotype and scored zero, so was told no chemo. (Mine was April 2013).....No rads, either, with the bmx.

My med onc felt strongly about 5-7 years on Anestrozol (think Arimidex) for post-meni, due to possibility of any other estrogen-grown cells showing up anywhere else.

The BMX removed need for radiation and of course reduced my risk overall. I believe I'm down to 2-5% now.

I am currently on a 6 month -schedule with Med Onc, who has me on Vitamin D and Ibanidrate for the effects of anestrozole, which so far have been quite tolerable, mostly some hot flashes and some joint ache. She does physical exams when she sees me; and I will need another MRI every couple of years, plus of course I stay alert to anything 'new' that I cannot explain as muscle strain. (I took implants same time as BMX so reduced my surgeries.)

so technically, you may be done with all but minor procedures, assuming no recurrence and looks like your risk is very low for that..Congratulations to you! Enjoy that gift of early detection and being alive when medicine is doing a great job of kicking BC's arse.

bluepearl · March 2014

Grade 1 with a 5mm tumor would have a very low risk of distant mets......mastectomies alone reduce local recurrences to 1-2%, and the chances of your tumor having travelled anywhere at that size and grade is pretty darned small. I'd wouldn't take tamoxifen since its se include liver problems, eye problems, possible deep vein thrombosis with your scores. I have to take mine because even though small, one was a grade 3. (small tumors have the greatest risk of recurring if they are Triple Negative, have Her+, and grade 3. You are none of those. Celebrate my friend, CELEBRATE!!!!!! (((hugs))))

Meghope611 · December 2017

I have a similar situation except my tumor was Grade 3 and Ki67 was >95%. Also I was diagnosed “young” (36) and post-partum (1.5 years from delivery). They keep telling me because my tumor was so small (5mm) that chemo isn’t called for but I would hate to miss a treatment option. Also, my tumor was weakly PR+ so it’s a little unclear if I should be categorized as triple negative or take Tamoxifen..

No other treatment after BMX?

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