No Chemo after Surgery...is this possible?
Hi. I am having a bi lateral mastectomy on July 30. IF, my lymph nodes are found to be clear, could it be possible that I will be cured and no further treatment required? Not looking for pipe dreams and pretend optimism...just wondering if anyone has had surgery, and not needed chemo or radiation after. I am fully prepared for chemo / radiation, but wondering if any of us here have not needed it. Looking forward to your comments. My surgery is in less than two weeks and my anxiety and darkness is high.
Comments
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yes, not having cancer in your lymph system is one indicator for no chemo.
Have the conversation with your breast surgeon and even better, an oncologist. Same for the radiation question- there are multiple factors at play for each. If I hadn’t had cancer in the lymph system I would not have had chemo
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Also, ask about the oncotype dx test, which also helps to determine whether chemo would not be recommended a helpful.
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You will probably have to go on hormone therapy, but no chemo or rads is absolutely possible.
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early stage low grade ER+ with no node involvement can mean no chemo or rads if you have mx. That was the case for me. I did bmx with immediate DIEP flap recon and started taking an anti hormonal pill a couple months later to keep the estrogen from fueling the cancer cells (ER+). Current recommendation is to take that pill everyday for 5-10 years. As you are ER+, expect them to prescribe tamoxifen if premenopausal and femara/anastrozole/arimidex if post-menopausal. There are boards on BCO for all of the anti-hormonal therapy options.
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I had BMX (cancer on both sides)with no chemo, no rads, Oncotype score of 16, Arimidex
So far, so good. It has been 4 years.
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You'll need either the mammaprint or oncotype test to decide if chemo is needed. Are you getting either?
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Elizabeth, yes it is possible that you do not need any chemo after surgery. I had no chemo, as I had complete pathological response and my lymp nodes became negative after initial chemo treatment. If that's not the case, you can have one of the tests - like Oncotype DX and Mammaprint that will help you decide if you need more chemo, I am sure your oncologist will explain. The latest cancer news has been that majority of early breast cancer patients do not benefit from chemo. Probably on this site as well.
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I agree that you'd benefit from the Oncotype test. Other factors that go into the chemo or no chemo decision are your age, the size of the tumor, its Grade, how strongly ER+/PR+ your tumor is (ie, how effective will hormone blockers be).
Fwiw, at my center they don't like to say 'cured' though. You may still be at risk of recurrence which might be significantly higher than the 1/8 probability of developing bc in the first place. It seems the term most commonly used after treatment is finished is "NED: no evidence of disease". The uncomfortable fact is that for a certain percentage of us, it will recur and kill us. We just don't know which side of the probability curves we'll end up on.You can input your tumor stats into a calculator like Predict and get an idea of how many people survive 5,10 & 15 years with just surgery alone.
http://www.predict.nhs.uk/predict_v2.1/tool
See how adding hormone therapy & chemo changes the outcomes (these stats are based are validated data sets but as always, they're from a few years back so for some cases, the actual current stats with current treatments might be yielding better survival rates). After your surgery and final pathology, your oncologist will run similar diagnostic tools and should present you with a treatment plan that lays out the percentage benefits of whatever treatment they recommend. At the end of the day, we all have to be comfortable with the risk/benefit analysis and make a decision that makes sense to us as individuals with complicated lives, dreams & whatever other health challenges we have.
About the rads - yes, I was told that if nodes were clean and the tumor was not very near the chest wall, rads would not be recommended after a mastectomy.
Good luck with your surgery. The waiting is hard - hope you're keeping busy.best wishes ~
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There are many of us who had neither chemo nor radiation, just surgery. It's very possible.
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