Questioning Treatment

Most people do chemo if that's what their docs recommend. The only ones I've read that were told ok for no chemo are stage 0 and 1. Lymph node involvement isn't the only thing to think about when thinking of chemo but if any of these suckers are loose in your blood stream, chemo would get it there. A lot depends on size of tumour, what kind of cancer (IDC, ILC, etc) it is, nodes involved, etc. Since much of this isn't really known until you get the surgery path results, it's hard to say what's the best thing to do at this point. So research is good but know that you don't have all your personal facts yet to make permanent decisions.

I'm 51. Most people want to throw the book at it at any age to possibly not go through it again. As for hormone therapy, the fact that your are ER+ it's a great idea to at least try it. You want to suppress estrogen production which if you are ER+ then estrogen has been driving your cancer as well. The higher the % the more estrogen has been driving it. You want to shut it down as much as possible, which is why I don't find many people not doing hormone therapy at the end of txs unless they are having bad side effects they can't deal with.

Having completed chemo a couple days ago, I will say that while it's not pleasant I feel that I threw the book at it because I sure don't want a recurrence and go through all this again. I look at people's sigs and wonder how on earth did this recur. Radiation is on tap next followed by hormone therapy for me. It looks daunting when you are just trying to wrap your mind around things and decide what to do, but once you have your sx and the path report and have it reviewed with your doc, things will start to flow better. And it makes a big difference in your mind once you have a plan in place and a date to start. Before all that I was kind of all over the place thinking no way this and that after some posts I read on side effects and such. But we are all different in how our bodies will react to tx. For me chemo overall wasn't too bad. I had a few bad days of nausea but other than that, nothing to note. There are meds to manage side effects. And I did it alone with no help which was a big concern for me.

So do your research. You'll be looking at other people's details in their sig more once you get yours but like I said, what is prescribed for someone similar to you may not be the right one for you. Ask questions and keep an open mind.

Best wishes to you and gl on your sx on Friday.

The Oncotype score was the defining factor whether or not to do chemo for me. As you can see by my signature, my diagnoses is similar to yours (so far) but the Oncotype came back in the intermediate range. My MO recommended chemo and reluctantly, I did it. If my Onctotype had come back low, I would have skipped it. If it came back as high, I would have done chemo willingly. I was reluctant with an intermediate score because the consensus on whether or not chemo benefits patients like me isn't out yet. I finished treatment in October. It was certainly doable and I have no regrets.

For me, hormonal treatment is not an option. I am doing it at least for the 10 years recommended. I think we're lucky to have a form of breast cancer that is so treatable.

I never had an oncotype score. My MO didn't think it's accurate enough to make decisions off of. All MOs are different in what they think about tests. I also didn't have tumour markers done. But that didn't worry me because I knew from the gate that I'm throwing the book at it.

Owens, you are in that horribl abyss between finding out you have cancer and putting the plan in place. After the lumpectomy you will have a lot more information. Thankfully, most BC is slow-growing, so you have some time to sort it all out. There is no head-long rush to do anything immediately.

My experience with chemo was much better than I anticipated. It's not like on TV, with the constant vomiting and gray colored skin. I had some nausea, but my MO have me meds for that. I never vomited and I looked great throughout. I did lose my hair and I was fatigued off and on, but for the most part it was business as usual. I think I missed about 5 says of work during chemo.

I will be taking a hormone suppressant, Femara, for 10 years. I also needed a double mastectomy and I will need a hysterectomy, all due to some serious gene mutations and awful family history. Otherwise, I would have just had lumpectomy radiation, and Femara.

Hi

I was 48 at dx, clear margins, no nodes, her2---really a great prognosis. Then the oncotype came back in the gray area.... took me about a minute to decide. I did 4 rounds of chemo-- had two small children and a full-time career--it was not easy, but I have to say, I sleep soundly every night---I know I did all that I could--- and my onc and surgeon ultimately agreed with me--they did not say I had to have chemo but they said things like "if you were my sister, I would twist your arm to do it".... It is ultimately your decision.... and I think it really depends on how you will feel about it-- will you be relieved to have skipped it or will you be anxious because you did not do it. I did 4 rounds over 8 weeks... did radiation and 5 years on an AI with ovarian suppression for 3 of those years. There really was not more to be done.... I do think age matters a little--so if you were 76 you might decide to forgo chemo. Not saying it was easy and I was lucky, did not have too many difficult side effects, but there are some, as there are with the hormonal drugs.... but as someone said, it is good that we have these options, and that is what they are, options.... you get to choose.

For me, the oncotype pushed me over the edge.... so I was able to calculate my distant recurrence odds--so for me (not sure I remember it perfectly) without chemo, I had something like an 18% chance that it could return. Having chemo reduced that number to 8 or 9%..... I thought it was worth it .....

There really are no guarantees and I am hopeful that since I had a slow growing bc that maybe it won't come back or travel anywhere else.....

Good luck-these can be hard decisions-but listen to the data then to your gut.... you will know what to do when you need to know it.

My Oncotype score was 27, which is in the intermediate range.
My MO told me that he couldn't say if the benefits to chemo would outweigh the risks for me. I just didn't feel comfortable with that. Chemo can have some pretty serious side effects! I would be more than willing to do it, but I need to know that it's going to benefit me.
Another factor that influenced me not to do chemo is that I had no cancer in the lymph nodes and got clean margins during my lumpectomy.
I went ahead with radiation and once that was complete, moved on to Tamoxifen. My tumor was 95% ER positive and 90% PR positive, so I know the Tamoxifen should benefit me greatly!

It all boils down to making what you feel is the right decision for yourself with the info that you have. That's really all any of us can do. Recurrence can and does happen with and without chemo.....there are no promises. So, make the decision that you feel is right for you and move forward with no regrets!

I wasn't expecting positive nodes either, even after the surgery - they doc thought they looked healthy.

It was a surprise to learn of one positive node and that chemo was recommended.

Standards still are the chemo is recommended if any nodes are positive. The Oncotype test didn't trump that in my MOs opinion. She would have been ok with me not doing chemo, but with an Oncotype score of 19 and one positive node, both my first and second opinion oncologists recommened chemo. As much as I tried to get out of it, who am I to question someone who was many years experienced in the field with my internet research?