Undecided and scared
Found a lump. Mammogram was negative. US was suspicious. Biopsy showed DCIS. Did surgery to remove it. Didn't get clear margins and path report showed invasive DCIS. second surgery got it as far as I know. Tumor was 21mm which puts me at stage 2, is ER+ but , PR- and HER2 - CT scan of chest, abd and pelvis clear of mets. Oncotype 20. Right in the intermediate risk. My cells are poorly differntiated as well. MO wants to be aggressive. 4 treatments of AC and 12 weeks of Taxol. Followed by radiation. I'm a 37 y/o single mom with 2 kids to care for.This just seems like a very aggressive treatment. How do you know if you are doing the best treatment? Wondering if I should get a second opinion. Any thoughts are appreciated.
Comments
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Hi SandraDee, I think a second opinion is always a good idea. Go to the best place you can (NCI designated if possible) and see what they say. I did AC/T and it's possible to get through it, lots of us do. Assuming your new dx is IDC, not DCIS? Good luck and let us know how it goes.
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If I were young, I would do the plan you recommended and if I had kids I would for sure do it. Its always good to get a second opinion. You might also want to reach out to women who have kids and how/if that factored in to their decision. Good luck.
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Was there any cancer found in yourlymph nodes?
I would definitely get a 2nd opinion if it wasnt found in nodes, but if it was chemo should be done. I did it and came out just fine.
So is it IDC now?
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I'm also in the second opinion crowd. But certainly much easier to do chemo at a young age
than an older age for most women. With those young kids, you do not want any regrets.
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I would get a second opinion just so you can feel more confident in your treatment decisions. You're young so you want to make sure you do treat it pretty aggressively, but if it is not in the nodes perhaps just AC or TC would be enough instead of all three. Something you could ask about anyway.
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Doyou know what grade your tumor is - low (grade1), intermediate (grade 2), high (grade 3). That makes a big difference in the chemo decision.
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If they are poorly differentiated then they are probably grade 3 (which sounds bad, but chemo is most effective in killing those fast growing cells).
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Check out posts by Lisey. She recently had a similar diagnosis, also young and PR negative. She did a ton of research and had a Mammaprint test done to help guide her. The negative PR sometimes means that the cancer is Luminal B, rather than the more common Luminal A. Luminal A cancers are typically grade 1, high ER and high PR positive; antihormonals tend to work well, chemo often not recommended. Luminal B is often more aggressive and responsive to chemo. Figuring out which one you are can be tricky. For sure get another opinion.
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she took one mode and it was clear. I reread my pathology report. My oncotype is 25 not 20 and idk the grade. But I had poor differentiated IDC and also DCIS in the tumor.
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I think you need more information before you can make your decision. Being in the gray area with Oncotype is the pits. As gracie22 said, a mammaprint can give you a better answer. Those results come back either high or low risk, no middle ground. Ask your dr for more pathology information, specifically, what is the grade, did they test for ki-67, has this been presented to the tumor board. Some Drs recommend chemo for everyone, especially if you are young. Some closely follow protocol, just not sure where yours falls. A second opinion would definitely help.
Two very positive things in your report are negative nodes and ER+. Being able to take something like tamoxifen is a big insurance policy just in case a few stray cells want to act up in the future.
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25 is on the higher end of intermediate, so it is not surprising that your MO recommended chemo. If you are still unsure you can ask for the Mammaprint which does not have an intermediate range; just high or low. You'd want to get it soon though, because these test all take a bunch of time. As others have mentioned, a second opinion is always a good idea. Best wishes.
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