Nothing after Surgery???

possible, but being ER+ 5 years of tamoxifen or an AI is probably on the table

In 1976 my Mom had a mastectomy with no followup treatment. She was 68 years old at the time. She passed away a month shy of her 99th birthday.

I agree with the above poster though, that tamoxifin may offer you extra protection!

You and I have a similar dx and situation. I just had my BMX, and I meet with an RO and an MO, but my surgeon told me I'm in a grey area of needing further treatment. I'm interested to see what they tell me.

Hi,

I had a BMX in August. No rads, no chemo. According to surgeon and Onco, tumor was very small, no nodes, not very aggressive etc. She was pretty confident I would not need chemo from the get go, but OncotypeDx came back very low and sealed the deal. Advised to take Tamoxifen which I will start soon.

I'm glad but I also know that it feels a little like is all that can be done, being done. Guess it was almost always given of Chemo years ago, and now they know it does not always offer additional benefits in some cases. So I see it as I'm going to be doing the best I can in hopefully preventing a recurrence. Take Tamoxifen, eat right, get plenty of exercise etc.

Hope it works out and you can do the same.

Hi there i had right mx and recon with no other treatment. I never even met an oncologist. I was very suprised that even tamox was never offered or discussed with me. When i asked why they said ' because you dont need it' and that was that i plan to ask how that decision was made at my next appointment.. not that i want to take it but all my reading suggested it would probably be benefical to me for protecting the other side. I think im having yearly mri for the next 5 years havent been to my 6 month follow up yet. I asked this question on here a while back and beesie wrote a really good reply that put my mind at rest. I "only" had dcis tho so a bit different to you. Cheers x aussie

You must have been very, very low in your Er ranking for him not to prescribe an anti-hormonal. Sounds like malpractice to me.

No I was actually 100% ER and PR positive and HER2- --> highly hormone driven cancer. My sis died of Uterine Cancer, until I hit menopause Tamox is not recommended. AI not effective until post menopause. Recs from ACS and NHLBI for treatment for the size of my IDC were exactly in line with their recs. My left node was negative for spread, but no way to know about SNB of right because it was never checked r/t a biopsy that stated it was not cancer but it turned out to be IDC.

I was recommended exactly was is evidenced based using the assumption that both sides/nodes were clear. The anxiety comes from the fact that my right was not checked because it was biopsied as non cancer. My chance of a microinvasion spreading is about 7%...Tamox side effects vs benefits does not do anything to improve that risk/reduce that risk without increasing the risks more of adverse side effects. Chemo benefits would have been the same...

The anxiety is a human side effect of all the "what ifs" because yeah the truth is it could spread - I could be in that %...or I could cause myself more harm and increased risks for other cancers by over treating....I revisit this subject with my MO in about 8mos.

Hi - yes I know about the AI and the ovary removal, which puts you into immediate menopause and therefore you would be post menopausal. I am 47yo and the removal of the ovaries also causes increased risk of CVD and all cause mortality. I am on the borderline age wise for risk vs benefit and this is exactly the decision I am making now with my Gyn-Onc for the CIN3. I am getting different medical opinions when it comes to ovary removal as well. I have gotten difference of opinions from providers I work with and other oncologists who I work with and the ones that are actually treating me it is actually a 50/50 split...research vs experience vs individual patient. I go back to my Gyn-Onc Sept 26th and she is actually the one that honestly will have the most impact on my decision. I have another appt with a different MO to get his input for the BCA, but I am up to 5 BO and MO combined opinions (for BCA) at this point (in addition to a tumor board)....and they all say the same regarding my case. I am even toying with the idea to have my slides sent to MD Anderson and schedule another opinion...because of some of the unknowns around microinvasions.

Cancer can spread through lymph and blood, and I showed no vascular invasion. My IDC was a micro-invasion 0.5mm, which absolutely trumps the DCIS and the Lob Neo...out of the 3cm that was found in the right breast 0.5mm was IDC --> so a stage 1A Tmic.. you are right - my line is confusing.

Peace... I am very similar to you. We found 9mm tumor idc/dcis on my clean breast upon my BMX. No nodes were taken as there was no indication of cancer in that breast even after mammo, ultrasound and 2 MRI's. I did have chemo and currently radiation on my known cancer side (right). Right was low ER/PR and surprise left side was 100/73. I will be taking tamoxifen after radiation which is only on my right. No radiation on my leftside and we are closely watching the nodes that were not tested. I still always wonder about the nodes on that side but with it being small, low grade, chemo and tamoxifen I hope I have I done enough.

I was also 100% and 95% ... AI are usually given post menopausal(in some cases pre-meno along with a shot to surpress ovaries) and Tamoxifen pre-menopausal. My Onco answered all my questions. Problem was I came up with more afterwards lol. So I called and spoke with the Nurse.

If all you have to do is take hormonal pill (Tamox or AI) I think we have to trust in out Dr's. Throwing everything at certain types of BC's that are looked as having a low occurrence is why the OncotypeDx comes in handy. To show that benefits may not outweigh the risks. Even if we could choose what types of treatment, if any, that we would want there is no guarantee that throwing everything at it or nothing at all would be the right choice. Everyone is different. Our genes, external factors etc. Way I've been learning to look at it. So I figure between the pill, trying to make lifestyle and eating changes that I'm doing the best I can.

I had a very small IDC. I had bilateral mastectomy. No residual cancer was found at all which means it all came out at time of biopsy. They were unable to locate my sentinel node (probably due to previous left reduction surgery). No axillary nodes were tested.

Tamoxifen was not recommended due to prior history of deep vein thrombosis.

I get anxious because they couldn't find the sentinel node, but my tumor was small and not aggressive. Tamoxifen would carry more risk than benefit in my situation.