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

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  • 39andhip
    39andhip Member Posts: 164
    edited September 2015

    @dtad - That is interesting. Do you have links to any of the articles?

  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited September 2015

    yesterday, the physician / researchers released a prospective study with respect to the OncotypeDX test! It is called TailorX....


    What it confirmed was it is an excellent determinant as to whether or not chemo is necessary BASED ON GENETIC MAKE/UP. While we are waiting for additional results from the study, probably in late 2017.... In the meantime we have an accurate test for a subgroup of patients that trumps traditional pathology examination

  • lintrollerderby
    lintrollerderby Member Posts: 483
    edited September 2015

    dyad and 39andhip: I've read that as well. It was awhile back and I'm not sure if I still have the articles bookmarked, but I'll take a look.

  • tshire
    tshire Member Posts: 239
    edited October 2015

    I've read that as well. It was something about the mitotic index- that is, if the other two categories (tubules and nuclear) are 3s and mitotitic index is 1 for a total of 7, that could be a lab error- something to do with formalin fixation time- and the tumor is more likely to be a grade 3, not a grade 2.

  • 4love
    4love Member Posts: 13
    edited October 2015

    This whole journey with breast cancer has been tough. Now to hear that there is no Grade 2....just Grade 1 and 3....makes it really hard to handle for me, because it means that my cancer is no longer considered moderate....now it's Grade 3 which makes it aggressive.

  • Ygammyyet
    Ygammyyet Member Posts: 8
    edited November 2015

    I am post four weeks with mastectomy. I am stage one with no node involvement. I'm waiting for my onco results. I am on arimidex and will undergo radiation in about a week. The radiation is my choice. It is hard for anyone to tell you what to do. I've chosen not to do chemo. Good luc

  • Beckers
    Beckers Member Posts: 1,883
    edited November 2015

    I am three years out, stage 1C tumor, grade 2, oncotype 19, IDC in R breast and DCIS in L. Only able to tolerate Tamoxifen for 10 months, no chemo. Still NDE.

  • grammakathy
    grammakathy Member Posts: 407
    edited November 2015

    I am two years from Mx, also stage 1C tumor, grade 2, Oncotype 11. No chemo was recommended. I started on Arimidex and had side effects and MO switched me to Tamoxifen after 1 year (which I have been on for a year now with fewer side effects.)

  • PatRN10
    PatRN10 Member Posts: 332
    edited November 2015

    gammyyet.

    Just curious. If you choose not to have chemo why get oncotype?

  • Meow13
    Meow13 Member Posts: 4,859
    edited November 2015

    My doctor ordered my oncodx my insurance paid, but I knew I would not do chemo based off the statistics too many variables.

  • sandylo
    sandylo Member Posts: 16
    edited February 2016

    i refused six months fec chemo had three weeks radiotherapy then on arimidex then exemerstane then letrozole i was told the chemo was a kind of insurance policy and advised strongly to take it however i decided against it i went through hell on the tablets hence the three different ones ive now been discharged and put on another five years of tamoxifen ten days ago im having strange heads still in pain and taking deep breaths like panic attacks if these don't subside in back to see my gp next week it was Sept 2010 when I had my op lumpectomy and sentinel nodes two were attacked so a month later had full node clearance still in pain from tablets and trigger finger from letrozole but keep plodding through im now 72 years old i love gardening so this keeps me going l. regards Sandy

  • JuniperCat
    JuniperCat Member Posts: 658
    edited March 2016

    I was recommended to do chemo by my MO, however (everyone has their own unique situation to guide them) I am considering opting out because the potential risks in my particular case (I have other health issues) don't seem worth the benefits. That being said, my BS wants to talk to me tomorrow about it. I would love to hear from other folks who decided to opt out and why

  • lorihoop
    lorihoop Member Posts: 19
    edited February 2016

    I was stage 1 grade 2, ER/PR+, Her2+. Oncotype score was 19, so I was on the very grey border but chose chemo just so I could have peace of mind that I did everything I could. It was 4 rounds of TC. Ovaries were removed September 2015, and I had had a hysterectomy 7 or 8 years ago due to a large fibroid.

    Was only able to make it through 2 rounds of chemo due to whole body hives and almost daily migraines, but the onco thought I did get some benefit from it and was OK with me stopping.
    Now I just take Arimidex. NED yet, and although it's only been a year, I expect it to stay that way since I had a double mx.

  • etnasgrl
    etnasgrl Member Posts: 650
    edited February 2016

    I am Stage 1, Grade 2, with an Oncotype score of 27.
    I refused chemo. My MO suggested chemo based on my age, (41), but could not tell me if the benefits to chemo outweigh the risks. I am node negative and received clean margins during my lumpectomy. I just couldn't put my body through chemo without knowing for sure, that I would receive some benefit of it.
    I now have 3 more radiation treatments left and then will go back to see my MO, to get on Tamoxifen.

    While I'll always be nervous about a recurrence, I feel like I made the best decision for me. I know of women who had a recurrence after doing chemo and I know of women who had a recurrence without doing chemo. I truly believe that so much of this is a total crap shoot.
    I will do everything that I can to be and stay healthy.....eat well, exercise daily, enjoy life, etc. If the cancer comes back, it comes back. Honestly, there is not much I can do about that except to deal with it if it happens. (Easier said than done sometimes!)

  • Pbrain
    Pbrain Member Posts: 863
    edited February 2016

    My MO and NP told me that grading a tumor was subjective and decided on by the pathologist looking at the slide. As an example, on biopsy I was a grade 3 but after lumpectomy, another pathologist deemed me grade 2. I would go more on the oncotype score, although I wasn't given the test because I was Her2+++ so it was pointless.

    So my message is, don't read too much into the grading system and trust your MO.

  • Meow13
    Meow13 Member Posts: 4,859
    edited February 2016

    I couldn't do the chemo either, my oncodx was 34. I was 53 at dx and so far so good. We shouldn't have to make hard health choices. I know some people sail thru chemo with no permanent side effects, but I just didn't think it was best for me.

    After 4 years I think I am done with AIs.

  • ChiSandy
    ChiSandy Member Posts: 12,133
    edited June 2016

    My ultrasound-guided biopsy said 7-9mm, IDC grade 2, ER+/PR+/HER2- Surgeon preliminarily staged me IA, pending nodes & margins, of course. I asked her NP at the pre-op teaching session about OncotypeDX, but she said they could only do it on surgically excised, not core-biopsy, tumor tissue; that most women clearly won't need it (because they obviously will or won’t be chemo candidates)--so because of the expense they save it for only those in the “gray area." (Wouldn't elaborate as to what constitutes “gray area").

    Surgical path report confirmed IDC grade 2 (nuclear 2, tubule 3, mitotic rate 1), highly ER/PR+ and HER2- (+1, which was considered “negative" rather than “equivocal"). Clean margins, 4 nodes (2 sentinel, 2 hitchhikers) removed, all negative. BUT the tumor size was 1.3mm. Still Stage IA, but tumor size was now t1c. Hello, “gray area." Told my MO I didn't want chemo because of other comorbidities, and she said she'd be very surprised if the OncotypeDX came back high enough to recommend it. Score came back 16, at the higher end of “low"--and she showed me the graphs that indicated that at almost age 65, my chance of 10-yr recurrence was 8% on an AI+radiation alone, but adding chemo would bring it down to only 7%--the risks of chemo outweighed any potential benefit in my case. Acc. to the AdjuvantOnline tool, chemo would give me only an extra year of life....with no guarantee as to the quality of that extra year.

    Mind you, had I been 44 or even 54 when diagnosed, I might have considered chemo. But bearing in mind that chemo kills only rapidly-dividing cells (malignant or normal), and my cancer, a Luminal A type, was slower-growing and probably wouldn't really respond to chemo, I might have been persuaded even then to have forgone it.

  • Meow13
    Meow13 Member Posts: 4,859
    edited February 2016

    Chisandy, also those numbers are with tamoxifen they are finding AIS are even more effective. I think you made the right decision I had the same break out as you on the grade.

  • KPittman
    KPittman Member Posts: 2
    edited February 2016

    Hello,

    I am curious about the same thing as I am leaning towards NO CHEMO as well. I am a Stage 1 but not sure of my Grade. Have you had many responses? I am new to the site and I'm learning how to navigate it but I have not yet figured out how to see responses to posts.

  • JuniperCat
    JuniperCat Member Posts: 658
    edited March 2016

    Hi, KPittman! I'm sorry for the duplicate response here (I also posted this elsewhere on the site): I am also stage 1 (grade 3), however, after the MammaPrint result came in, two MOs and my BS suggested I do 12 weeks of chemo. I opted not to do it because of negative nodes and other health issues. For me, it wasn't worth the potential risks involved. If you are unsure what to do, don't hesitate to seek out another opinion. Also, you may want to request a copy of your pathology report and copies of your various scans. Your tumor grade should appear on your pathology report.

  • Scottiee1
    Scottiee1 Member Posts: 2,329
    edited February 2016

    stage 1, grade 2, oncotype 19 and chemo was not recommended

  • katcar0001
    katcar0001 Member Posts: 621
    edited February 2016

    What's the cut off for "young?" I don't consider myself that young, but then not old either ;-). I was 50 at diagnosis, 51 at surgery (day after my birthday). Tumor was 1.5mm, mitotic rate 1, ki-67 4%, nuclear grade 3, tubular grade 2, overall grade 2 (read on another thread that grade 2's should really be classified as grade 3?!). Oncotype 17. Three doctors said no chemo, just Tamoxifen for a few years, then switch to AIs when confirmed post-menopausal.

  • ChiSandy
    ChiSandy Member Posts: 12,133
    edited February 2016

    I read generally that between Grades 2 & 3, the most important factor is degree of differentiation from surrounding normal cells, followed by mitotic rate. Tubule score was not as important. Mine was tubule score 3 (the higher the proportion of tubules to overall tumor cells, the lower the tubule score and thus the better), mitotic rate 1 (slowest-dividing) and “moderately differentiated” (i.e., moderately different-looking from surrounding normal cells), adding up to Grade 2. Grade 1 is “well-differentiated” (very different-looking from and fewer than surrounding normal cells) and Grade 3 “poorly differentiated” (nearly identical to surrounding cells which are also not “normal” looking). So I don’t see how Grade 2 should be relabeled Grade 3--there really is a middle ground. Most Luminal A tumors are Grades 1 or 2.

  • goodprognosis
    goodprognosis Member Posts: 251
    edited February 2016

    Hi KPittman.

    Click on or save, if you havent already done so (Breastcancer.org discussion boards) to your Favourites/bookmark.

    If you add this topic thread (see at top of the topic and click on 'My Favourite Topics' , it will be added and the number of new posts will show up on the left hand side bar where it says MY FAVOURITE TOPICS in bold print every time you log on. You can do this with as many 'Favourite Topics' as you like.

    You need to log in every time to see the new posts but you must have already done this to post.

    Best of luck,-----hope the above is clearer than it looks on re-reading it!!!!!!

    GP

  • Sunnyone22
    Sunnyone22 Member Posts: 191
    edited February 2016

    ChiSandy - you seem to know so very much about the details of BC - your posts are extremely helpful. Perhaps you can answer a questions for me. In post-menopausal women, it a high ER% better in terms of anti-hormone treatment? My initial biopsy showed 100% ER+ with strong staining which indicated to me that my ILC was VERY driven by Estrogen. Does it stand to reason, then, that any remaining cells will be VERY responsive to AI (or Tamoxifen)?

    Your thoughts?

  • herb
    herb Member Posts: 51
    edited February 2016

    my score was 25, I opted for Chemo. .. I am taking the hormone blockers for 10 years. I am in a group and see lots of METS. Since you can't go back I would make sure I took the hormone blocker for 10 years or what ever your doctor advises. but i would not do any less since that is the only line of defense you have at this point

  • nurse88
    nurse88 Member Posts: 14
    edited May 2016

    I had colliad Mucous carcinoma only 5% present of women have this it is rare. I was stage 1 grade2, no lymph node involvement , no chemo, had radiation thru a Savi, all clear margins after lumpectomy after everything was over I was put on Hormone Receptor. This was in Aug. 2015, 8 months later came back in same breast on the opposite side, going back in for surgery 5/25 this year, This time it is under a vessel my biopsy is undertermin they don't know what it is just stated it should be removed.

  • Moderators
    Moderators Member Posts: 25,912
    edited May 2016

    Dear Margiep, Welcome to the community. We are sorry about your diagnoses but glad that you reached out here. Stay connected. Keep us posted and let us know if we can help you navigate the boards. The Mods

  • Tmh0921
    Tmh0921 Member Posts: 714
    edited May 2016

    I was stage IB, grade 2

    I was diagnosed at 27, in 1999 and they didn't have the Oncotype scoring then.

    I didn't do chemo (my oncologist and 'tumor board' didn't feel I needed it) just lumpectomy, node dissection, radiation, and 2.5 years of Tamoxifen.

    I'm 16 years out

  • Sunnyone22
    Sunnyone22 Member Posts: 191
    edited May 2016

    Tmh0921 - ALWAYS good to hear from someone as far post-BC as you (16 years). Thanks for chiming in and letting us know - inspiring for all us newbies.

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