Anyone who was Stage 1 Grade 2 who did not do chemo?

4love, wish I didn't have to welcome you to the group. My story is similar to yours as I was diagnosed at age 40 with a Stage 1, grade 2 IDC however my oncotype was 11. I am on the 10 year plan for Tamoxifen but did not do chemo as the benefits would have been minimal. I had a double mastectomy and did not have radiation or chemo. Currently on year 4 and doing well.

Hope this helps ease your mind some.

oncotype 19

Your opening post did not provide as many details as you might think, so I am not sure how to comment to you. For instance, 25 is a fairly high intermediate score. Did your Doc ever run the Adjuvant Online program for you which tells how much of a benefit (in percentage) doing chemo would have given you. I know that my doctor sees the 5% risk reduction as the point in which the benefit outweighs the risk. So, I wonder what percentage of benefit chemo would have given you? For another instance, Grade 2 is weird, a grey area. You might want to look further into the pathology which could break that score down into the three component scores, most specifically mitotic (growth) rate. If you scored a "1" on that, perhaps your tumor would be too slow growing to benefit much from chemo; on the other hand, scoring a 2 or 3 on that could indicate that chemo would have greater effect. Finally, also contained somewhere on your Path. Report (or maybe the Biopsy Report) should be the percentage of ER positivity you had. If you were strongly positive, like 90-95%, then an anti-hormonal (your Tamox.) would be the drug of choice as far as adjuvant--insurance policy--treatment. I take it that you had no positive nodes. Many with early Stage, without node involvement get to skip chemo.

What comes to my mind is that when a woman is "young", aggressive BC is more prevalent and more of their BCs are not strictly estrogen dependent. For that reason, many "young" women are candidates for chemo moreso than older women. However, if your pathology was reviewed by two doctors and they both concurred that chemo was not required for you, then don't worry too much about it.

Check into the few things I mentioned and, as always, go back to the doctor source and simply ask WHY chemo was not considered. Just to ease your mind and gain understanding. I believe that all questions like that need answers and who cares if it is two years down the road, ask!

I'm 36, dx last year with IDC stage I, grade II, ER/PR + and Her2 -, oncotype 11. No chemo, no rads. Currently on Zoladex and Tamoxifen, because tamoxifen caused an increase on estradiol levels. I also worry about recurrence, but I dont think I would worry less if I had done chemo...

I didn't do chemo even though my Oncotype was 21. My MO said there was a low percentage (below 3%) difference with chemo. I felt confident with her recommendation. My SO said 95% of her patients opted out of chemo with my scoring. I am being treated at Cedars Sinai in Beverly Hills.

hi 4love

i also did not go thru chemo.

mine was stage 1 and grade 3, but the doctor did not suggest to go for chemo.

Hi 4love and all.

I couldn't just read and run.

I'm 2 years out!!

No chemo, no rads just mx

And I had 3 IDC with a DCIS that was necrotic comedo ( I think that's the worst that in-situ gets, or something. Someone correct me if I'm wrong, I'll be happy!) They only test the largest tumor, ugh, that has gone round my mind - what if the smallest tumor was HER2+, what if it was ER- ... have I been given the right treatment. I'm gradually feeling better about it, sometimes even manage a "so what, whatever" ha.

My surgeon and onc both said no chemo, and we had quite a long debate about it, involved second opinions. Their reasoning was good and I understood it.

Elimar, you are so right when you say: "Ya know, someone has to be in the statistical group that "beats" breast cancer, so why not you? That's what I always tried to focus on and so far so good."

x x

Hi 4love,

As you can see in my signature, I had an LX a couple months ago for a 5mm tumor of pleomorphic ILC. I'm starting rads next week and am on Tamoxifen for a minimum of 10 years. My Ki67 was 7%, so the mitotic rate of my tumor was so low (and it was so small) that chemo was not recommended for me. I had a few detailed conversations with my MO and got second opinions along the way. I wouldn't say I'm content with the decision for no chemo (I doubt many of us are content with any parts of this situation!) but it definitely makes sense in my situation. Second-guessing seems to go hand in hand with everything to do with BC but I absolutely agree with the previous posters - if it's bothering you at all, make an appt with your MO and quiz them as to their reasoning.

Good luck!

I have stage 1, grade 2 IDC with an oncotype of 13. I've seen two different MOs and neither recommended chemo for me. They said it might benefit me 1-2% but ultimately that benefit would probably not outweigh the risks. I think I tend to lean toward conservative treatment, though. I really didn't want to do chemo... I also really didn't want to have a mastectomy, but that apparently has to happen. I, too, get nervous about whether I'm doing the 'right' treatment, but I think second guessing yourself is inevitable no matter what, unfortunately. Like someone above said, if you read stories about recurrent and/or metastatic BC, it can happen regardless of whether or not one does chemo.

There is a test to see if you can metabolize tamoxifen but lots of OCs, including mine, don't/won't use it.

Dear Mabs:

My MO gave me a test to see whether I could metabolize tamoxifen.  The results stated that I was a poor metabolizer of tamoxifen.  That is how I know that I can't metabolize it.

Regardless, Aromatase Inhibitors are slightly better for Invasive Lobular Carcinoma and LCIS.  That being said, there isn't that much difference between the two.  Since I was not in menopause at the time of my diagnosis, my MO would have prescribed tamixifen if I could metabolize it. 

I started with Zoladex to suppress my ovaries and put me into menopause.  (One must be in menopause to take an aromatase inhibitor.)  However, I did not want to take an extra medicine and have the zoladex shots every month.  I had an oophorectomy to put me into menopause. It is a relief because now, I will not have to worry about ovarian cancer and I am taking one less medicine. 

Most doctors will not do the tamoxifen test, and even if a test is done, most doctors do not place much stock in the results.  Doctors tend to feel that tamoxifen will work anyway.  I am glad that my doctor gave me the test. I would rather take a medicine that I know will work 100% for me.  Both tamoxifen and arimidex are strong medicines with potentially, a lot of side effects.  If I were taking tamoxifen, I would always be wondering if it was working.

Good luck to everyone on this thread.

614

i don't think size is as important as the genetic makeup of the tumor these days.