stage 1. grade 2 recurrence question

hi Did your oncologist suggest any chemotherapy being that you had a positive lymph node??

My lymph node had a micromet of 1.5mm. To count as a positive node, there needs to be at least 2mm of cancer, so my situation is called clinically negative. However, cancer cells did make it to that node, so my oncologist ordered the Oncotype test to see if I should have chemo. The test came back low, so no chemo for me. I went on to radiation and am now 3+ years into tamoxifen.

>The risk of having cancer develop in the other breast, especially if you had ER+/PR+ cancer is extremely low. The risk is usually stated at 0.5 - 1% per year, but a recent study found it to be even lower - at 1% at 51 months. The risk is slightly higher for ER-/PR- cancer.

Kayb, can you give us a link or links to your source(s) of information?

I'm not doubting you!--I'd like to read up on this topic. Thanks--

Well, even if the risk is extremely low, there is still some risk of contralateral breast cancer even for us who have ER+/PR+ IDC tumors. I am an example. After my initial diagnosis of Stage 1 IDC, ER+/PR+ in my left breast, plus very extensive DCIS, my suspicious radiologist recommended an MRI and eventually -- after many a biopsy and double mastectomy -- a second, smaller stage ! ER+/PR+ IDC tumor was found in my right breast as well --bilateral/synchronous (at the same time) invasive breast cancer. I believe the radiologist pressed for further investigation because of what he called my "extremely active breast tissue, which we often find runs in families (my grandmother died at 49 of breast cancer, but I am not BRCA positive)." Only the first, larger tumor was tested by the Oncotype DX test (low recurrence score), and my oncologist said "We'll treat both cancers at the same time" That, for me, meant just anastrozole after surgery, no chemo and no radiation.

I think it is important, and reassuring in a way, to note that a contralateral breast tumor is virtually always a new primary tumor -- it has not spread from the other side and does not represent a metastases (or even, technically, a recurrence). As breast cancer patients, we are followed carefully, with regular mammograms of remaining breasts, and the new second cancer is likely to be found very early. The prognosis for bilateral breast cancer is usually stated to be about the same as the prognosis of the more advanced cancer of the two.

Dear Hodgy,

You have to check the prescription for the mammo or ultrasound. If the doctor only recommends one side, you can ask your MO to write a prescription for both sides. I would imagine that your MO will comply. However, you must look at the prescription prior to the day of the mammo. I always ask for a copy of my prescription rather than having the doctor send the prescription to the mammogram office. I like to contact them rather than the other way around. If you have dense breasts then you may also need an ultrasound as well.

Good luck.

Thanks for the links kayb and all of the useful info that many people posted.

I had DCIS grade 3 in one breast and DCIS plus IDC plus a positive sentinel node in the other.The grade 3 DCIS is what showed up on mammogram--the IDC and DCIS in the other breast didn't. Make sure both breasts get checked (if both weren't originally), and that both get annual imaging.

Hodgy, I ask the same questions as you.

Why is the unaffected breast treated as though it doesn't exist?

Why doesn't anyone think the other breast will get cancer?

On and on... My questions just keep coming! I read everything, always just looking for hope!

At the end of the day, I want the reassurance and yet I'm discovering no matter how similar our stats appear, we are all different and just have to push our doctors for answers -- even if for just peace of mind.

I wish us all peace.

Christine

Hi Hodgy, I read your post about the oncotype dx test. I don`t think it would be to late to get it even now. My tumor, or part of it, was sent from one hospital to another in Mo. I would check back with the hospital that did your surgery. You should be able to have this information. Hope you are still doing ok and I tried the peppermint oil.

very helpful on the mammos ladies. Unfortunately I don't have a clue what it's like to have a normal mammo - I had my first mammo, then right away a diagnostic mammo, then the ultrasound and off to MRI I had gone. So I have no baseline really. In October they did a mammo of only the affected breast, which I thought was weird. I'm due in April for another set, and I will make sure they look at both!