Positive lymph nodes after mastectomy

My recommendation is that you have a long think about a few things--how do you feel about aggressive treatment, are you a very healthy and active 84-year-old, do you have a lot of other medical conditions (like diabetes, heart disease, emphysema) and what do YOU want to do. Would you be willing to go through months of chemo, with all the risks involved, especially for an individual your age?

Then you should have a conversation with your oncologist. Why are they recommending no chemo? What are the risks and benefits of chemo for someone in your circumstances? Would chemo lengthen your life? Would their treatment plan change if they knew there had been metastasis to other organs, like bone, liver, or lung?

Sometimes less is more. It could be that your team is avoiding a more aggressive approach because they believe it's in your best interest. ER+ tumors tend to be slow-growing and they might believe the aromatase inhibitor/zometa and radiation will allow you as many years as you might have had, without the added risks of chemo. Still...talk about it. Get some answers.

Please keep in mind that in many cases of a slow-growing ER+ cancer, chemo is often not at all effective, or is of so little effect that it doesn't change the course of your disease. But it absolutely can change the quality of your life, and might in and of itself shorten it. I continue to have side effects and I was only 51 when I went through it. At grade 2 I had such a small showing for it that I almost wished I hadn't done it. I feel pretty strongly that the reason I'll still NED has more to do with Tamoxifen than it does with the chemo I did. So please don't feel as though you are being cast aside as not being worth any effort because of your age and the fact that they are not recommending chemo. A combination of aromatase inhibitors and a bisphosphonate is liable to be way more effective in slowing down a very slow growing cancer than any chemo currently available.

Even if you are really Stage 4, if the cancer is slow-growing, it may not be worth doing anything other than what was recommended to you, i.e. that may give you the longest possible life span. I agree with the earlier poster that you should definitely discuss this aspect of it carefully with your MO, in consideration of all aspects of your health.