making a decision on whether to get chemo or not

Femail, was there any cancer in your nodes? I assume not if your stage is 1. 

Radiation is generally every day for 6 weeks. Chemo is given every 3 weeks. ( Dose dense is every 2 weeks, I had that, stage 3 ).

Maybe he is recommending a new radiation regimen that I am not aware of. Very possible, there are lots of treatment options. 

Did he talk about taking a drug for 5 years, either Tamoxifien or Arimidex ? The oncologists can tell you the benefit of chemo, what % of protection you might receive. Usually with stage 1 it is a small %. The more advanced the cancer the higher the benefit.

I have not been through chemo. I am still awaiting test results. However, I know that if it were me, I would do the chemo. I's sorry that you are having to go through this.  But, be tough!

I would not have chemo in your circumstances.  There are lots of other things you can do to give yourself the same % benefit that chemo would.  Cancer  spreads via stem cells and no chemo kills cancer stem cells so if your tumour or cancer cell load is not very high chemo could do more harm than good.  I was stage 3 on diagnosis and refused chemo, I do not regret it as it was the right decision for me, you need to get to a point of knowing what is the right decision for YOU, not the statistics...........

femail1956,

I had an Oncotype score of 48 just like you.  This is a VERY HIGH score.  This means that this cancer has a 32% chance of coming back in a distant site (or metastasize) within the next 10 years.  (I was also node negative like you but I had two tumors - one 2.3 cm and the other 1.6 cm).  I am ER+ and PR+ for both tumors, and this gives me more options of treatment.  It looks like, your Oncotype report indicated that you are ER- and PR-, and therefore, you may not have anti-estrogen choices, although if you were 33% ER+ in your pathology report, the doctor is very likely to try the anti-estrogen treatment.  With our score, chemo does wonders.  If you have chemo, your recurrence risk goes down from 32% to 15% - a more than 50% relative reduction, and a 17% absolute reduction.  This is huge in the cancer world.  I would take your doctor's recommendation on this.

Edited to add that the score ASSUMES that you will be on an anti-estrogen such as tamoxifen or an aromatase inhibitor for five years.  The score (and the recurrence risk) would be higher if you do not take the anti-estrogens.

When I was initially dx everything pointed to Stage I BC in my r breast. I was so grateful and relieved but opted for BMX with reconstruction. That may have seemed like using an elephant gun to kill a beetle, but my intuition told me this was the right treatment. After 9 hours of surgery a much clearer picture emerged, my  Sentinel node and 3 out of 4 other nods were positive for BC. This meant chemo regardless of an Oncotype score of 9. I was devastated to find out BC had spread to several bones. The thought of having to undergo chemo was practically worse than the thought of cancer.  I was supposed to have 6 rounds of TC every 3 weeks but did 5 rounds which wasn't nearly as difficult or taxing as I imagined. I would have lost all my hair had I not used Penguin Cold Caps. It took 4 rounds of TC to get me to NED but I "volunteered" for the 5th round, sort of icing on the cake. Anyway, I think everyone fears chemo and the side effects associated with it. My experience was much more manageable than I expected and although I didn't really have a choice, I can't imagine not using everything possible to kill the cancer. Looking back and trying to analyze the highs and lows, chemo wasn't the worse part of my entire experience. It's a little like labor, the contractions hurt like hell, but in the end there's an amazing gift waiting for you, your baby. Chemo, to me is like labor..and the gift, NED which I couldn't have gotten to, without chemo. Good luck with your decision and I hope if you do choose TC it's as easy for you as it was for me.

Amy

Have you had the BRAC analysis done? you mentioned a gene expression panel.  You can always get another opinion. For me, SE's of chemo were not real bad. No regrets. I wanted to fight it with all I had while I could. Chemo can be hard for some people, but it's usually not as bad as we envision. It's not something I would want to do again, but it was manageable. There is a website called cancermath, I think, that may give you an idea of benefits of treatment options. Not sure how accurate it is. Good luck with your decisions and treatments! Ultimately, it is up to you. Follow your gut!

Femail, 

How are you feeling? Having NO cancer in the nodes is comforting. Mine were full of it. 

My chemo regimen was very aggressive, no choice. I think there are so many factors to consider, age, general health. I have friends who were in your situation. One had chemo, the other chose radiation only. They both did 5 years of  Tamoxifen. Both are doing great. Getting 4 chemo infusions would be 3 months. That combo is easier than other chemo drugs. ( For most ladies ) Also getting it every 21 days as opposed to every 14 gives your body time to heal. 

"Cancer spreads via stem cells and no chemo kills cancer stem cells". This is taken from a post a bit earlier on. If this is true, why does chemo exist at all? Or perhaps I don't understand what you were trying to explain? Can you explain this a little differently please?

I think the people advising femail to not do chemo, or talking about people they know who have done great without doing chemo need to be cautious.     Please note that femail's Genomic expression report finds that she is NEGATIVE for ER and PR, and her original pathology report found that her Estrogen receptor percentage was very low, only 31%.   She is also HER-2 Negative.     It's not clear if an oncologist would even try using a hormonal therapy in Femail's case, and if he did, I doubt anyone on this board is qualified to guess what likelihood it would have to be a successful therapy all by itself.        

Femail, Ask your Oncologist to explain to you the meaning of your test results and your risk and how chemo would affect that risk.   Did your Oncologist tell you that there are therapies you could do that could significantly reduce your risk if you don't do chemo?    

(By the way, WAS your gene expression profile panel an Oncotype test, or was it perhaps a Mammaprint test, that has relevance for both hormone receptor negative cancers as well as positive ones??         48 would be a high risk Oncotype score-- Not sure what it would mean if the test was a Mammaprint test.    

chemo kills normal cancer cells, and there are millions of those once a tumour or mass emerges, and that is why chemo can help, but no chemo destroys cancer stem cells, only our immune systems can do that. i don't need to "defend" it as its simply a fact,  google cancer stem cells and chemo, it is very well documented. 

I emphasize it is a unique decision for each unique person, amd my only recommendation is to do what is truly right for you. 

femail,

I just wanted to let you know that, although not a walk in the park, I did find chemo to be a lot easier than anticipated. I even went out to dinner with friends after my initial (dose dense AC) chemo infusion.  I hope you will also find it a lot easier than anticipated.  The best of luck and hugs.