Why am I fearing 'No Chemo' recommendations?

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IrishKatie55
IrishKatie55 Member Posts: 33
edited January 2017 in IDC (Invasive Ductal Carcinoma)

My IDC has been diagnosed early stage, 1.9 cm, had Lumpectomy (left) on Dec 28th, was eligible and had internal balloon radiation treatments, 10 rad treatments in five days. I am healing and cooling down right now. Told they got to clean margins and nodes. My BSurgeon, and RO have both indicated my initial pathology looks good and could be heading for no chemo. Met with my Oncologist last week and we are still waiting on Oncotype test results to firm up initial pathology. She also said same possibility of anti cancer inhibitors with no chemo IF %'s remained in low area. I am 61 , Post menopausal After initial biopsy the hospital pathology showed Ki-67 at 38%, after surgery same hospital shows Ki-67 at 20%. Guess Oncotype results will be more accurate when they come? Looking at all the posts and information on the forums I see folks with the same or even lower / early diagnosis and #'s but having chemo as part of treatment plan. No chemo should be good, positive news but am having anxiety about this decision. I trust my docs but would appreciate input and any advice. My husband found this site for me and from day one it has been a great source of relief and strength as we go through each early stage of this Cancer journey. Many brave and strong souls out here.

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  • keepthefaith
    keepthefaith Member Posts: 2,156
    edited January 2017

    IK, Hang in there. I have a similar DX as yours. I had a 21, intermediate onco-score, so my MO left it up to me as to whether I did chemo. I went ahead with chemo even though I was scared to do it. If you happen to be in the gray score 18-30, you can see if your MO will order another test called the mamma-print. It gives you a high or low recurrence risk score. You can always seek another opinion. Did you have the BRCA test done? Any family history or other health issues? Sometimes the anti-hormonal drugs are all you need. Even with chemo, unfortunately, there is no guarantee that you won't have a recurrence. I understand your concerns and wish you well. PM me if you like.

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited January 2017

    Hi!

    If your Oncotype test shows that the risks of chemo outweigh the benefits, the "no chemo" recommendation is highly defensible. You have to remember that some BC patients get chemo because of the type of cancer they have, not because of their stage or whether they caught it early. BC patients with HER2+ cancer (like me) typically get chemo because most doctors won't give Herceptin (a targeted treatment for HER2+ cancer) without it. Oncologists are also likely to recommend chemo to BC patients with triple negative cancer (ER-PR-HER2-) because hormonal therapy wouldn't provide therapeutic benefit to them.

    Best wishes!

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  • Positive2strong
    Positive2strong Member Posts: 316
    edited January 2017

    Hello,

    I was told I could not do Chemo after radiation.


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  • SpecialK
    SpecialK Member Posts: 16,486
    edited January 2017

    positive - the type of rads the OP is posting about is not the same as regular rads. She is referencing mammosite/brachytherapy balloon catheter rads, which is done quickly after surgery and only takes a week. Chemo can indeed follow that type of rads, but not the traditional type that takes a number of weeks to accomplish. If a patient is not eligible for brachytherapy then, you are correct, the normal sequence is that rads follows chemo.

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  • IrishKatie55
    IrishKatie55 Member Posts: 33
    edited January 2017

    Yes, Chemo after radiation was an issue I asked about and was advised as SpecialK shared. It could happen with this type of rads if determined it was needed later. My Radiation was 2xper day for five days. Liquid/seeds directly through catheter to the area of removed tumor. Your information will be very helpful when I see my doc next week and figure this out.

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  • KBeee
    KBeee Member Posts: 5,109
    edited January 2017

    While it's nice to have a tumor with "good" characteristics, it's normal to feel scared that they're not being aggressive enough. Wait to see what your medical oncologist recommends. The Oncotype will help you with this recommendation and you can always get a second opinion. If it comes back low, and all opinions agree that they advise against chemo, then remember that chemo works best on fast growing tumors with aggressive pathology. It has its risks. You'd still be taking hormone therapy which is a very powerful weapon in your arsenal. It is very hard waiting and not having a plan. I think it's the most stressful time. Hoping you have a plan in place soon and that it's one that you and your docs are confident with.

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  • Lisey
    Lisey Member Posts: 1,053
    edited January 2017

    ON the KI issue. My KI was a '30%' and my oncologist completely discounted that high number showing me studies that say Ki is an eyeball test that even pathologists won't agree on a number for the same slide (that was the study, they sent the same slide to top pathologists and no two numbers came back alike one was 5% one was 35%)... So I wouldn't obsess about a higher ki at all. Wait for your oncotype, and if it comes back in teh middle, you could always ask for a mammaprint like I did which not only confirmed the LOW ki score my onc thought, it said no chemo.

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