My (perhaps controversial) thoughts as a "newbie" to CA.

I think your feelings are entirely valid. I think if I felt that way I would wait to see more details when I had my appointment and I would give it some time to think about it. I would refuse to be rushed into making decisions until I was ready. I might consider doing a lumpectomy only if I were still determined not to do any further treatment. I would also be very up front with the doctor about why I felt the way you do about nausea, etc. and see what they have to say, because there are definitely ways they can much improve your prior experience. I think a lot of women here will tell you that treatment was not nearly as bad as you are envisioning

You are right, it is an intense time. And the worst part really is at the beginning when you are bombarded with information & then have to try to make rational decisions in the middle of a tornado of emotions.

What did they say at your appointment yesterday? If you are willing to share, we will try to help you wade through the information and can give you some tips about things that helped us make decisions, and helped us through various treatments as well.

Such a scary time diagnosis is. And you were brave to post a potentially controversial thread.

Pursuing no treatment is a valid option. It's a valid option for all of us, really, but we follow doctor recommendations as if they actually have the answers. We hire doctors--they're our employees--and they can make recommendations, but the decision is ours. Don't be afraid to tell them what you think or ask questions you want answers to, though I know it can be intimidating.

I'm 49 and not pursuing conventional treatment beyond surgery (I am using alternative treatments), so I totally understand why you would not want to put yourself through all of that. There are no guarantees with or without treatment. Each person has to decide for themselves how they want their life to be after diagnosis.

TRill1943 - You don't have to make a decision today.  Tell your oncologist all of this. Ask him/her how much difference each additional treatment will make in your prognosis.  If you are estrogen and progesterone negative you won't need the hormonals.  If the IDC tumor is really small, chemo might not make that much difference, and I didn't get sick to my stomach once during chemo, the anti nausea drugs these days are amazing, food did taste really crappy though.  Make a list of your concerns, maybe even print out your post above and ask him to address these issues.  At first it's really overwhelming - but this site is a great place to get info and support!  God bless you, Linda

Trill, one thing to consider is that surgery, if they can get clean margins, and no node involvement, is about 70-75% curative. please think long and hard about doing at least the surgery.

and one other thing, I did chemo and never had any nausea, zip! And I never took anything other than what they gave me for infusions and the steroids two days before and two days after. And not all chemo is the same, some are easier to do

Yes I do. All the treatment scared the crap out of me. I had negative er and pr, and they told me I had no choice but to do chemo. Looking back, with great surgical margins and no node involvement, I will always wonder how much chemo helped. I have grandkids though, and I wanted every fighting chance to be here to see them grow.

I think the least treatment should be surgical removal. They could get it all out with a lumpectomy, and then you can decide on everything else after surgery. It takes at least four weeks to heal from surgery before any further treatment would be contemplated. 72 is young by today's standards. I am 53, and if mine comes back, I think I would probably just have the breast removed and not do reconstruction. My great aunt Josie had a tumor similar to mine removed at my age, and she lived to be 99. There are still a lot of years ahead of you to live.

Not trying to put any pressure on you. I found the lumpectomy surgery to be no big deal at all

Trill, the absolute worst time to make treatment decisions--one way or the other--is in the few days after diagnosis. It’s a punch to the gut, a screeching halt to what we all thought would be forward progress in life, and all you know is that you’ll be making a hard turn instead--but will it be left or right? The one turn it can’t be, as much as we would wish it, is a U-ey. There’s no hopping backwards over that break in time.

I concur with others here that if you are unsure about which way (and whether) to proceed about treatment, it would be wiser to consult a medical oncologist first rather than a breast surgeon. At 64, knowing the estimated size, grade and profile of the tumor, I was definitely sure I’d have surgery, but not sure whether mastectomy or breast-conservation. I had no idea what lay ahead after that, but because I’m only a tad younger than you and have some comorbidities, I was very fearful of chemo. So my first stop was the breast surgeon, and she referred me to the medical oncologist for a post-op appointment once the surgical path report was in and they knew more about the tumor. She also was able to assure me that for a tumor of my stage, lumpectomy + radiation had the same survival rate as mastectomy--and that prophylactic mastectomy isn’t always indicated if the tumor is small, in an “opportune” location, the breast is larger, diagnosis is later in life, and there’s neither genetic mutation nor family history. (I know I’m in the minority around here in feeling that absent any exigencies and high-recurrence-risk factors that a bmx for me would be overkill. I also hate surgery, and a lumpectomy is shorter with a faster recovery).

Where are you being treated (“treated” meaning including diagnosis, consultation and planning)? I would urge you, if it’s at a smaller community hospital--especially in a small town--to seek a second opinion at a major university-affiliated hospital with a comprehensive breast health program and cancer center. In a small hospital your surgeon is likelier to be a general surgeon, not a breast cancer specialist (and he or she may also be the one performing biopsies, rather than a radiologist with special expertise in breast disorders). Your surgeon, no matter who, won’t get any “do-overs:” you want the appropriate procedure for you done correctly the first time, with the most up-to-date knowledge and techniques. It’s worth the drive (or flight) to get that. Adjuvant (post-op) treatments can be done closer to home.

But only you have the final say as to what’s right for you. Your medical oncologist can tell you the pros and cons of chemo; if your tumor’s not only hormone-receptor-negative but also HER2+, there are targeted biologics such as Herceptin available to you. And once you do decide on the type of surgery (assuming you decide in favor of surgery), you still don’t have to decide on which if any further treatments you want until the pathology report is in on the tumor, nodes, and margins. It’s not unheard of for an initial biopsy to over-or-under-estimate the size of the tumor, as well as its grade, receptor and genetic profile. Mine turned out to be larger than estimated--though still “small”--but slower-growing.

When, after my lumpectomy, I met with my oncologist for the first time and told her why I was leery of chemo, she laughed and told me not to get ahead of myself--rather, she first wanted to know all about me: where and with whom I live, what I do, what I love to do, what matters most to me. All of that has bearing on what to do going forward. She told me that there were all sorts of things they do nowadays to improve immune response and prevent nausea and neuropathy--but that I would likely not need chemo due to my age and the surgical path report. (She also ordered the OncotypeDX test to further determine that--but it’s ordered only for small estrogen+ tumors without lymph node involvement and with clear margins). A really good medical oncologist, since she or he will be leading your treatment team, needs to know as much about you as possible in order to treat you as a whole person rather than a tumor.

It’s up to you to assess what is most important to you, especially how you feel about what if anything you still want to achieve in life and who (human or animal) depends on and loves you. Life as you know it will change--but maybe not as much as you fear it will. Do let us know what you learn from your care team and how you will proceed--whichever way you turn.

ChiSandy's post is great, lots of good information in there! I second, get all the data. And breathe! And move forward one step at a time, otherwise it seems so overwhelming

I can't say for 100% that negative receptors mean chemo, but it did for me. You could come back as grade 1, which is slow growing and not as affected by chemo. It's really hard at this point for you to know since you don't have all the data available yet.

Just try not to let your focus be on chemo. there are lots of horror stories out there, but honestly, people with issues tend to be more vocal. Chemo never stopped me from living my life, working, exercising, watching grandkids, anything. Was I impacted? Yes, definitely. But nothing like I expected at all. Four months of kind of crummy, and now it ended almost six months ago and I don't even remember what it felt like anymore.

Get all the data, and don't let people push you until you are comfortable. My doctors said that by the time mine was discovered it had probably been there for 5-7 years, and the time from diagnosis to surgery for me was almost eight weeks. Get an opinion, get a second one, and then go with what you feel best. I got four opinions before I was ready to make a decision.