Why don't all invasive need chemo

I have invasive and its grade 1. My doctor did not recommend chemo because she said its not very effective against low grade cancer and I will get a bigger bang for my buck with Arimidex.

I do not believe so. I've read my reports and don't recall seeing that. Mine is IDC Stage 1A, Grade 1 and ER/PR positive just like yours. I had feared chemo but when she said she didn't recommend it, then I felt almost worried that I didnt' have it. But I have read about the studies for the grade 1 and I go to a breast center and it was reviewed by a tumor board so its not all just one doctor reviewing the records. It seems to vary, I even have a friend with DCIS whose doctor tried to get her to do chemo and that seems really odd. So are you having radiation? I would have had to have radiation if I had done the lumpectomy but the placement of my two tumors and one papilloma made mastectomy necessary.

My oncologist never suggested chemo or even tamoxifen because she said I had no breast tissue after bilateral bmx. Only yearly routine visits with primary. This should be reassuring but it actually scares me. No oncotype done at least noone mentioned it. Genetic testing was done.

Lillp07 I had vascular invasion and I am doing chemo. I also had one lymph node positive. I am also grade 1 and keep hearing things about chemotherapy not so great for grade 1. LVI scares the crap out of me so I just want to do all that I can. My MO also said that chemo is to mop up any rogue cells out there. I didn't want to do chemo either, but it hasn't been as horrible as I thought.

Nancy

Oh and I did not have the oncotype test either. I asked and my MO said because I am premenopausal the oncotype test for that group is in the clinical trials (with positive nodes). She said she could put me in the trial but she was afraid I would end up in the group without chemo. I do trust my MO so here I am doing chemo.

I'm doing neoadjuvant Femara with a very strong response so far. If the nodes are clear at surgery (after 6 months on Femara), I probably won't need chemo. Of course, the final pathology is what we'll rely on. However, from the beginning my MO has made it clear that chemo was not an absolute, despite an aggressive tumor and positive node.

I am amazed at how well the tumor and node are responding to Femara and it's great to have this information NOW rather than taking it for 5-10 years and wondering if it's doing anything.

Lillp07, Oncotype test is not standard in Australia. You can have it done but it would cost about $4000. 

You could ask to see two oncologists. It doesn't hurt to get a second opinion when making such a huge decision.

Keep us posted.

ps I'm in Brisbane. This is an awesome site!

Hi again Lil. Another reason to get opinions from more than one oncologist is that there are several types of chemos and the number of treatments recommended (4, 6, 8 or more than 12) also varies.  If you do have to have chemo, you will want to choose the one that will work best for you and cause the least side effects!

TrishaAnne

Which chemo regimen are you doing? Your diagnosis is similar to mine except I am HER2neg... but was still told I needed chemo. Scary how different treatments are for almost similar diagnosis...

Lill

I did FEC and found it fairly tolerable. The week of treatment was the worst. I would have my treatment, work the next day and depending on how I felt worked most days, but only a few hours a day. My biggest problem was diarrhoea, so had to be near a toilet all the time. Some people have the opposite problem and have constipation. You won't know until you do a round how you'll react.

Make sure you take all the anti nausea meds they give you, even if you don't think you need them. It's more important to stop the nausea before it starts, than try to stop once you start throwing up. I never threw up once. I did feel a bit queasy from time to time, but never actually threw up.

Food didn't taste great and I got really tired, but apart from that (and the big D) I didn't have too many problems.

Once you have your first treatment, you'll get an idea of how you will react to it and will be able to plan your work around it a bit better. Make sure you drink lots (and I mean lots) of water with FEC. The E part  (Epirubicin) will make you pee pink for a while and it's important to flush it out of your bladder.

I bought a tube of Emla cream from the chemist. It's a numbing cream and fairly expensive, but if you put it on about an hour (two is better) before your treatment, you hardly feel the needle they use to access the port.

I came through FEC pretty well and if I had to do it all over again, I'd do FEC without any misgivings. Don't be scared about it - I know that's easy to say - but really it's not that bad. I was soooo stressed before having my first chemo treatment that I had a seizure as they were accessing my port. When I finally got my first treatment two days later it was (almost) a non event.

Take something to keep you occupied while getting treatment, FEC takes a long time. I think I was in the chair around four hours or maybe five.

Trish

xoxo

Sangar,

Are you hormone positive? If so they should order the OncoDX/Type which will "help" determine whether or not you would benefit from chemo. Because 10% of those with ER/PR + IDC may or may not benefit from chemo the Onco test further studies the genes involved in your cancer. It is also my understanding that if we are hormone positive we have to be treated with Tamoxifen or an aromastase treatment because the estrogen in our bodies can attach to the cells and cause problems

http://www.breastcancer.org/symptoms/testing/types/oncotype_dx

Lymph Vascular Invasion. When noted on your pathology report it means that lymphatic and vascular development is seen within the sample and this potentially shows a pathway for the spread of cells from the tumor.