Is a year of chemo common for breast cancer after mastectomy?

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RCraig
RCraig Member Posts: 10
edited November 2015 in Chemotherapy - Before, During, and After

To make a long story short my wife is from Ukraine but we got married 9 years ago and she now lives in the states. Her mom came to visit in August and during a routine checkup got diagnosed with breast cancer.

She had a mastectomy on one breast and now the doctor is saying she needs a year of chemo. Is that normal that she would need a whole year of intravenous chemo? Her Nottingham score is 9/9 (tubule formation -3, nuclear pleomorphism -3, mitotic rate 3). We don' t have any idea what these numbers mean.

Here are some more numbers:

- Estrogen receptor Positive with 99% of nuclei showing strong intensity staining

- Progressive recepto less than 1% staining and negative.

- Hercep Test positive with 3+

- Ki-67 proliferation index 22%

Now my wife came to the room upset tonight that her mom is thinking about not doing chemo because she's reading all this stuff in Ukraine about how bad chemo is. Does anyone know any info on the survival rate for doing chemo vs not doing chemo? What are the chances of it recurring with chemo vs without chemo for her type of cancer?

My wife is stressing about this not knowing what to tell her and I just want to provide her mom with info so she can make her own educated decision and my wife can stop stressing about trying to convince her. If we give her the info she can make her own choice I just don't know what to tell her.

Here is the full test results and diagnosis.

page 1 - http://postimg.org/image/60rxpdw3h/

page 2 - http://postimg.org/image/q82j40xbx/

page 3 - http://postimg.org/image/nk0ltz409/


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  • HazelFrances
    HazelFrances Member Posts: 70
    edited November 2015

    i am not an expert at all. A year seems long to me. My suggestion is to get a second opinion. If you can find a doctor that your wife and mother in law trust, I think that would help. You didn't mention finances as a barrier, but if her mom is here on a tourist visa, I'm not sure how that works. I hope you have insurance for her and that everything works out for all of you.

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  • KBeee
    KBeee Member Posts: 5,109
    edited November 2015

    Herceptin will likely be given for a year. Herceptin is not chemo, even though it is an infusion. It is a targeted therapy. She will likely have 4-5 months of chemo and Herceptin and then just Herceptin. Best wishes

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  • doxie
    doxie Member Posts: 1,455
    edited November 2015

    KBeee is correct. For HER2+++ cancer Chemo is the norm for 4-5 months with Herceptin continuing for a full year. Your mother-in-law has a very aggressive cancer and it needs to be taken seriously. Someone who had HER2+++ and 9/9 on the Nottingham score may be able to give more info.

    So sorry you have to all go through this.

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  • muska
    muska Member Posts: 1,195
    edited November 2015

    Hi Craig, I am not an expert in the type of BC that your mother in law has but from what I know she was recommended the standard of care in such cases. As the ladies before me explained Herceptin is not chemo and is considered a breakthrough treatment that greatly improves the survival. I browsed through the path report you attached, it appears surgical margins were not quite clear or maybe I read it wrong. I am sure somebody more experienced will comment. She will be put on hormonal therapy that is likely to be very helpful because of her highly positive ER status.

    You didn't mention your mother-in-law's age but for some reason I think she is probably a relatively "young" woman - maybe in her early 50s? If that is the case and if she is in good health otherwise it might make sense to do as much as can be done. Please feel free to PM me, I can talk to your mother-in-law in the language she speaks or to your wife if they want to talk to somebody who went through treatments recently.

    Best of luck.

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  • RCraig
    RCraig Member Posts: 10
    edited November 2015

    HazelFrance - i am not an expert at all. A year seems long to me. My suggestion is to get a second opinion. If you can find a doctor that your wife and mother in law trust, I think that would help. You didn't mention finances as a barrier, but if her mom is here on a tourist visa, I'm not sure how that works. I hope you have insurance for her and that everything works out for all of you.

    Another thing is that since her Mom is from Ukraine she has no insurance and my wife and I have been paying most medical bills out of pocket. We've literally spent thousands of dollars trying to help her but we're just mentally and financially drained at this point.

    She's putting some of the surgery costs on a bill at the hospital but we've been paying doctor visits to the specialist, reconstruction surgery, and part of the surgery costs which is at least $15,000 at this point. I'm scared that if she needs medication we won't be able to put that on the bill and we can't afford to pay anything else at this point. Is Herceptin in pill for or through IV? She could do the IV and they would add it to her bill we'll make payments on but if in pill form wouldn't we have to pay out of pocket for that?

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  • RCraig
    RCraig Member Posts: 10
    edited November 2015

    muska - You didn't mention your mother-in-law's age but for some reason I think she is probably a relatively "young" woman - maybe in her early 50s? If that is the case and if she is in good health otherwise it might make sense to do as much as can be done. Please feel free to PM me, I can talk to your mother-in-law in the language she speaks or to your wife if they want to talk to somebody who went through treatments recently.

    She's only 53. She doesn't really speak English so that would be amazing if you could talk to her. She's reading a bunch of online sites from Russia and I don't know what kind of info she's viewing. I don't think she understands the seriousness of it. At this point I think she is just freaking out and looking for answers. I'll PM you soon.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited November 2015

    rcraig - Herceptin is an IV infusion that is given with chemo - it is not available in pill form, and each of the rounds of chemo and Herceptin can be close to $20,000, if not more, depending on where you are being treated.  Herceptin alone, which continues for the remainder of the year, every three weeks after the chemo is done, can be close to $10,000 each.  You need to speak with the financial counselors at the oncologist's office and address how to pay for this if she choses this type of treatment, and whether there are any programs available to cover the cost.  I know that Genentech, the maker of Herceptin, has a program that helps with cost share, and the folks at your center should know about it.  This is a problematic situation and I wish you the best.

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  • RCraig
    RCraig Member Posts: 10
    edited November 2015

    Thanks so much for the advice everyone =) Does anyone know statistics of survival and recurrence rate with chemo vs without it for her type of cancer? I just want to show her the statistics and try to convince her to do what is best. She's so young and don't want to see her pass on chemo becasue of some website with bad info.

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  • muska
    muska Member Posts: 1,195
    edited November 2015

    From what I understand there is resistance to doing any further treatment be it in the US or anywhere else. Please let her know that with medications that they now give the side effects like nausea are minimal. My chemo course lasted over 6 months and I was never nauseous. Hair loss is a temporary thing and a good wig will make her look great. Most women her age continue working through chemo here in the US and that was my case too.

    Speaking of Ukraine maybe you can look into trials that are rather often conducted there and fully funded by Western partners, European in particular. I think her medical oncologist or hospital in TN should be able to search for such trials and explain whether she qualifies from medical standpoint.

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  • RCraig
    RCraig Member Posts: 10
    edited November 2015

    She could go back home for treatment but from what my wife and her are saying the medical system there isn't as good and they think she'll be get better treatment here. Do they have places there where she could get chemo and properly treated?

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