Micromets in node - chemo or no?

Staceybee-

I had a positive node that was originally classified as macro, but second opinion at Dana Farber reclassified it as micro. (To be fair, a lot of stuff was reclassified every time someone new ran it; It’s really scary how subjective this all is! )

Anyway, they also had it tested for Oncotype- score was 14. My MO still wanted to do “chemo lite” because of my age and node involvement. I opted not to because I knew rads and Tamoxifen were going to give me the best odds and I wanted to get that rolling.

According to my Oncotype report, chemo actually gave me worse odds for 5 year survival! Glad the tailorx trial came out, makes me feel more secure in my decision.

Good luck!

I had 2.1 mm in one node and didn't get chemo because of my mammaprint results. Different but similar to oncotype. I was 38 at the time too. They did radiation to all my lymph nodes though, as a result.

I did not have more nodes removed. That was one of the reasons I needed a second opinion, because my surgeon wasn’t sure what she wanted to do. Even at the tumor board, there was disagreement. Because of my age, tumor size, and node involvement, I didn’t fit into any of their “boxes”. Both my surgeon and my MO encouraged me to get a second opinion in Boston.

So all my imaging and slides went up to Dana Farber to a doc who specializes in breast cancer in young women. They have their own pathology go over the slides and imaging, that’s how it got reclassified.

If you are comfortable with your treatment plan and it seems clear cut, you probably won’t need a second opinion. If things get complicated, you may want to get one. I am still surprised how often the results changed.

Hi, don't want to scare anyone, even though fear is just part of this journey, but I had only 1 micro met when they did my mx. So BS was happy, but sent me MO because I had 3 tumors in left breast. After all my initial testing and scans at onc office, it showed that mine didn't go through my nodes, but via the bloodstream and was already in several bones. So, my advice would be to do chemo to knock out any chance of trace cells. I found chemo was yucky with lots of SE's, but manageable. It's only for a few months and you can look back and say "I did it, its over". And maybe enjoy life with a little more peace of mind

Just my take on things, but we are all different and handle this road differently. And that's ok.

Take care,

Jenny

So, it's been many years since I posted, but I will say I had 2 micromets and in 2011 they were considered negative. My Oncotype was a 22 and I was 47 with two young kids so I opted for T/C x 4. I also did RADS and in the end Tamoxifin and I just didn't get along. I am now 7 years out and so far so good.

hi Staceybee, I was 50 when dx. Had bilateral mastectomy with bilateral sentinel node biopsy in 2010. Surgeon took two nodes from each side and pathology found micromets in one node. Oncologist recommended chemo and I agreed so we didn't do the oncotype test.

Onc said no radiation so I didn't have to decide about that.

Did six rounds of TC chemo (taxotere and Cytoxan), five years of tamoxifen (was in peri-menopause when dx), then switched to anastrozole (now in full menopause) and will do five years of that. Three down, two to go, and so far so good (knock on wood). Best wishes and gentle ((hugs)).

I know someone that had 1cm tumor ILC near chest wall, node negative, oncodx test score of 4. She did lumpectomy, savi radiation and I believe tamoxifen. Not quite 6 months later they discovered ILC cancer in bone, hip. She probably was already stage 4 at diagnosis. Oncodx can give you info on your chance of recurrence and maybe how well chemo will work it can't tell if your cancer has already spread.

Hi Stacey,any updates on your treatment? Have you made a decision about chemo?

Meow...very sad story about that someone you knew...Did she have a PET scan before starting treatment?

I am currently also in suspence about my treatment, meeting with oncologist on July 10th.

See my dx below, the one positive node was with micromets. They were fairy confident no axilary dissection was necessary, because it was the first one (the one which lit up during tracking). the next in row were clear...

but I suppose my grade and her2 status scream full siege with chemo and targeted therapy and radiation...

I don't know if my friend had a PET scan before getting radiation. It was the radiologist she had when she was doing savi. She told me there was alot of pain and that radiologist did some sort of biopsy and pathologists determined it was the ilc cancer. I wonder how they do a bone biopsy. It must have been MRI or PET scan guided. Anyway she was in good spirits it was a single bone met and she was treated with radiation. I have not seen her since I retired from work. I really hope she is ok.