Grade 3 but no chemo treatment

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Anx789
Anx789 Member Posts: 168

Hello, I was just diagnosed with this horrible disease. Is it almost certain for a grade 3 tumor to have a chemo? I’dlove to hear from those that chose not to have chemo.

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  • Beaverntx
    Beaverntx Member Posts: 3,183
    edited October 2018

    Anxiouslady, As you can see from my stats, my tumor was grade 3, meaning it was aggressive, and I did not have chemo. Your treatment plan will depend on many factors, including ER, PR, HER2, etc. Also, likely your Oncotype score. There is a lot of information about all of these on the main site here, which I found very helpful. There is so much that I am not going to post a link here as you need to start where your greatest questions are. That information can help you prepare a list of questions to discuss with your doctor(s)--keep a note pad handy so you will have a written list to take with you to your appointment. It is almost a guarantee that you won't remember them all otherwise! Best wishes to you as you continue on this journey that none of us chose. Keep in touch and feel free to ask questions, there are lots of wonderful people on here.



  • Meow13
    Meow13 Member Posts: 4,859
    edited October 2018

    Are you strongly er and pr positive? If you are have the oncodx test to see what the risk is. If you are er, pr negative you will probably be advised to do chemo. Chemo is most effective on fast growing cells.

  • Meow13
    Meow13 Member Posts: 4,859
    edited October 2018

    wow at 77 having ovary removal?

  • Anx789
    Anx789 Member Posts: 168
    edited October 2018

    Biopsy shows ER+(90%) PR+(2%) HER2-,

  • Beaverntx
    Beaverntx Member Posts: 3,183
    edited October 2018

    meow13, yes ooph/ hysterectomy at 77! Pelvic ultrasound before starting Tamoxifen showed a thickened endometrium. That biopsy was negative for cancer ,but due to concerns about uterine cancer, my gyn surgeon was willing to do a total hysterectomy since I really wasn't making much use of those organs anyway. Turned out to be a good thing as the uterine pathology showed some premalignant cell changes. Who knows what would have happened if I had gone ahead and started the Tamoxifen without having the US? That takes one worry off my list of what ifs.

  • Ingerp
    Ingerp Member Posts: 2,624
    edited October 2018

    HER2+ is more associated with automatic chemo. Other factors include tumor size and whether or not there is lymph node involvement, which you won't know until after surgery. Assuming the lymph nodes are clear, you'll probably have an Oncotype test to see if chemo would be beneficial.

  • Meow13
    Meow13 Member Posts: 4,859
    edited October 2018

    Beaver, wow I was 53 but post menopausal so I went right to AI treatment. No one mentioned ovary removal but probably because I didn't have uterine issues. I was just suprised many pre menopausal women have surgery you have.

  • Meow13
    Meow13 Member Posts: 4,859
    edited October 2018

    Anxious, the pr at 2% might drive the oncodx score up. Let us know good luck to you. You should ask if AI drugs would be better for your case.

  • Beaverntx
    Beaverntx Member Posts: 3,183
    edited October 2018

    Meow, did not start with AIs due to long history of osteopenia. Have a dexa scan scheduled later this month to see if the osteopenia is stable or progressing--if it is not one thing it is another! That said I am delighted to be around to need such testing.😁

  • Anx789
    Anx789 Member Posts: 168
    edited October 2018

    thanks for the input. I’m going to ask my Onco regarding A1 treatment, what is it anyway? My surgery is not till10/16/18. I’m leaning towards bilateral, any idea on this too?

  • Meow13
    Meow13 Member Posts: 4,859
    edited October 2018

    AI is aromatese inhibitor given to post menopausal patients. There is some evidence that suggests it works better than tamoxifen particularly on er+ pr- patients. You are 2% pr so you fall closer to er+ pr-, it might be right for you.

    Letrozole, exemestane and anastrozole are AI drugs.

  • Meow13
    Meow13 Member Posts: 4,859
    edited October 2018

    Anxious I had a single mastectomy left side. I had 2 tumors 1 IDC 1ILC both 1 cm separate tumors. I am 95% with er and 0% with pr, her2- and no nodes. Seven years out, no cancer.

    I had a DIEP reconstruction and a lift on real side. I am very happy with the cosmetic result.

  • Anx789
    Anx789 Member Posts: 168
    edited October 2018

    Meow, I am very glad to hear that. What are your tumors’ grade? My US shows 2 tumor but during biopsy they can only find 1. I feel the tumor is bigger than 2cm or there are actually 2 not 1, I can feel it compressing and seems like sometimes it’s weight is pulling my left breast. I am really freaking out. Strong family history of cancer in father side, 3 of my aunts have ovarian or uterine cancer, 1 aunt had breast cancer, my dad had lymphoma. Everybody still alive and kicking except for 2 aunts.

  • Meow13
    Meow13 Member Posts: 4,859
    edited October 2018

    One of my tumors was grade 1, a 5 of 9 on nottingham, mitotic rate 1. The other was grade 2, a 6 of 9, mitotic rate 1.

    I couldn't feel the tumors, neither could doctors, they were close to the skin surface. I was told no skin sparing, simple mastectomy was the board recommendation. The pathology after mx was really excellent considering. My surgeon said it was a very good report he was confident there were no lingering concerns. However, as you know there is no way to know for sure. Chemo was recommended after oncodx scoring. Everything I have learned since then has pointed to my absence of progesterone receptors with a high er percentage. This case has been seen as aggressive and not as responsive to tamoxifen. One theory suggest my cancer my have stopped feeding on estrogen but most of those cases are grade 3 and her2+. Impossible to know if my tumors feed on estrogen. Studies have shown AI drugs to be much more effective than tamoxifen for er+ pr- cases.

  • Meow13
    Meow13 Member Posts: 4,859
    edited October 2018

    One of my tumors was grade 1, a 5 of 9 on nottingham, mitotic rate 1. The other was grade 2, a 6 of 9, mitotic rate 1.

    I couldn't feel the tumors, neither could doctors, they were close to the skin surface. I was told no skin sparing, simple mastectomy was the board recommendation. The pathology after mx was really excellent considering. My surgeon said it was a very good report he was confident there were no lingering concerns. However, as you know there is no way to know for sure. Chemo was recommended after oncodx scoring. Everything I have learned since then has pointed to my absence of progesterone receptors with a high er percentage. This case has been seen as aggressive and not as responsive to tamoxifen. One theory suggest my cancer my have stopped feeding on estrogen but most of those cases are grade 3 and her2+. Impossible to know if my tumors feed on estrogen. Studies have shown AI drugs to be much more effective than tamoxifen for er+ pr- cases.

  • bevin
    bevin Member Posts: 1,902
    edited October 2018

    hi there,

    I was grade 3, and was offered chemo. I had a couple consults. One Onco said def yes as I was onmy 45, another said I'd be fine without it. I elected to go without. I am 8 years out and doing well. I didnt have lymph node involvement and if I did, my choice would have been different.


    Good luck to you.

  • Anx789
    Anx789 Member Posts: 168
    edited October 2018

    Hi Bevin, did you have hormonal therapy

  • Cat_Lady
    Cat_Lady Member Posts: 8
    edited October 2018

    I was diagnosed at age 26 with Stage 1 grade 3 IDC Er+ Pr+ HER2- with clear margins and no node involvement. I didn't go through chemotherapy however I am on tamoxifen. I agree with Bevin if I had node involvement my decision would've been a different story. Have you decided on your surgery? Lumpectomy or mastectomy?

  • Anx789
    Anx789 Member Posts: 168
    edited October 2018

    Cat lady, I am 49 yrs old and deciding whether to have a uni or bilateral mastectomy. I’m leaning towards bilateral MX but still needs to weigh the benefits and risk of bilateral mx

  • Cat_Lady
    Cat_Lady Member Posts: 8
    edited October 2018

    I had a bilateral mastectomy done March 5, 2018 with tissue expanders placed. I just recently got my expanders exchanged for implants August 14, 2018. My reasoning for getting the bilateral mastectomy and not the single mastectomy or lumpectomy was reassurance. I didn't want a single mastectomy because I didn't want to chance getting cancer in the other breast. Lumpectomy was out of the question. Are you interested in reconstruction surgery?

  • Anx789
    Anx789 Member Posts: 168
    edited October 2018

    I’m not interested in reconstruction right now but would like to have that option later on. Does mastectomy eliminates the chances of getting breast cancer or just lessen it

  • Cat_Lady
    Cat_Lady Member Posts: 8
    edited October 2018

    That's completely understandable it's a difficult decision. You should consider a skin sparing bilateral mastectomy that way when you do decide to do reconstruction there is extra skin there for you to stretch. Unfortunately recurrence is possible even with a mastectomy. It doesn't eliminate the chances but it does lessen it. Which is why the bilateral was worth it to me. Once a year you would have to get screened (MRI).

  • Motheroftwinkies
    Motheroftwinkies Member Posts: 10
    edited October 2018

    I would suggest you do an Oncotype or Mammaprint. I had a grade 3 tumor, ER/PR + HER2 -, lymphovascular invasion, one lymph node involved but my mammaprint score came back as low!!! So for now i am taking a pill.

  • bevin
    bevin Member Posts: 1,902
    edited October 2018

    hi yes, I did take hormonal therapy and 36 rounds of radiation.

  • Anx789
    Anx789 Member Posts: 168
    edited November 2018

    Bevin, What is your oncotype score? Mine came out 54 😞, the thought of chemo is freaking me out.

    Motheroftwinkies- is mmammaprints comparable to oncodx

  • Palesa2018
    Palesa2018 Member Posts: 140
    edited November 2018

    Sorry to hear that your Oncotype score is high Anxiouslady. Wishing you strength right now.



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