Chemo or No? HELP

I would be inclined to go with chemo, but that's just my opinion. Being so young, we always hear there is the higher risk of it being aggressive. 3.5cm is a fair size and I would be worried. Chemo is an insurance policy, not to say it always works, but then you did everything you could. Diet and exercise also go a long way. I've heard people who keep up with exercise, experience a lower risk of recurrance. I was Dx at 34

If I were in your shoes I would do chemo due to tumor size of 3.5 and your age. I chose to throw everything at it because if I had a recurrence and hadn't thrown everything at it I would have felt so bad about my decision.

An OncoDX score of 14, negative nodes, clean margins, hormone+/HER2- status, and a tumor grade of 1, regardless of age, would indicate that despite the OP's youth and tumor size chemo would not be sufficiently effective to warrant the risks (albeit smaller than in older women with more vulnerable hearts, bones & immune systems). Grade 1 is the least aggressive cancer, sometimes described as “indolent." Its slow-growing cells are not very vulnerable to cytotoxic chemo. The OP called her invasive cancer “mammary" but didn't specify whether ductal or lobular. ILC is sneakier than IDC, so sometimes chemo does get prescribed for it. Also, some MOs will prescribe neoadjuvant chemo to shrink tumors that large, to facilitate breast-conserving surgery--but the OP already has had the tumor removed, via mastectomy.

I would definitely seek a second or even third opinion--giving chemo to node-negative grade 1 IDC tumors (Luminal A) scoring 17 or lower definitely goes against the current grain. Size is less relevant, given that both the tumor and breast have been removed. Endocrine therapy, however, is definitely indicated--whether a SERM (tamoxifen or raloxifene) vs. ovarian suppression or removal followed by AI is a personal decision for someone so young; considerations include decisions about future fertility and the likelier rougher SE's of being thrown into premature menopause--the estrogen withdrawal would be far more abrupt and precipitous than in women past menopause. But chemo also can induce at least a temporary menopause (“chemopause") as well.

Where in WV is Hinton and how close is it to a topnotch cancer center at a major university teaching hospital? Perhaps a trip to NC’s Research Triangle area--Raleigh’Durham/Chapel Hill (Duke), Phila. (Penn), NYC (Memorial Sloan-Kettering), Baltimore (Johns Hopkins), Boston (MGH or Dana Farber) or even Chicago (U of C, Rush, Loyola, Lynn Sage/NWM) or Houston (M.D. Anderson) for a second MO consult might be worth it--the treatment agreed-upon could then be administered closer to home. Dr. Kathy Albain at Loyola (near w. suburbs of Chi.) was a pioneer in developing OncoDX and its predictive value.

I am going through that pressure of choosing or not choosing.I am choosing.Mine was 17 and tubular 2 nuclear grate 2 and mitoic (?) 1.My tumor wAs 8 mm.My oncologist had said he first thought it would be lower.It was my choice but I too feel I have to give it all I got right now

An important question may be "what chemo is being recommended?"

No chemo is fun, but some regimes are better tolerated with less risk of long term effects. If it's a matter of 4 months of TX with little long term effects, maybe go for it.